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目的探讨肾球旁细胞瘤的临床病理特征、诊断与鉴别诊断。方法对于2012年11月21日就诊的1例肾球旁细胞瘤的临床表现、病理改变和超微结构改变进行观察分析并作文献复习。结果患者临床表现为高血压、高肾素血症、高醛固酮血症和低血钾。左肾实质内见一巨大肿瘤,行左肾切除术。光学显微镜下见形态一致的多边形或圆形肿瘤细胞呈片状、巢团状或围血管生长,可见血管外皮瘤样构像;免疫组织化学呈CD34弥漫阳性,平滑肌肌动蛋白局灶阳性,广谱细胞角蛋白、上皮细胞膜抗原、S-100、人黑色素瘤特异性抗体、嗜铬素A、突触素均阴性;透射电子显微镜下可见特征性菱形晶体(前肾素颗粒),确诊为肾球旁细胞瘤。结论肾球旁细胞瘤是少见的肾脏肿瘤,易误诊为其他肿瘤,知晓该病并熟悉其组织病理学和超微结构特征是正确诊断的关键。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of renal allograft tumor. Methods The clinical manifestations, pathological changes and ultrastructural changes of 1 case of glomerular mesothelioma treated on November 21, 2012 were observed and analyzed and reviewed. Results The clinical manifestations of patients with hypertension, high renin hyperlipidemia, hyperuricaemia and hypokalemia. See a huge tumor in the left renal parenchyma, left nephrectomy. Under the light microscope, polygonal or round tumor cells in the same shape showed flaky, nesting or perivascular growth, showing vascular endothelial neoplasia; immunohistochemistry was diffusely positive for CD34, positive for smooth muscle actin and wide Spectrum cytokeratin, epithelial membrane antigen, S-100, human melanoma-specific antibody, chromogranin A, synaptophysin were negative; transmission electron microscopy can be seen characteristic rhombic crystals (prerenal particles), diagnosed with kidney Paracellular tumor. Conclusion Renal para-tumor is a rare renal tumor, misdiagnosed as other tumors. Knowing the disease and being familiar with its histopathological and ultrastructural features are the keys to correct diagnosis.