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原发性肾细胞癌者的血清AFP阳性(>20μg/L)者罕见,我院收治1例,现报道如下:患者女,43岁.因臀部感染伴有发热十余天,于1994-09-08入院诊治.查体:一般情况良好,心肺、肝、脾正常,腹腔未扪及包块.B超检查及CT扫描均发现左肾中后段占位性病变,血清AFP值为283μg/L,HBsAg(-).9月27日行左肾切除术,术中探查肝、胆、胰、脾、胃肠等正常.切开后腹膜见左肾边缘不规则,后外侧可扪及一质硬并凸出肾皮质的肿块,约5cm×4cm大小.肾门和下腔静脉旁见肿大淋巴结,遂行左肾切除.术后病理检查发现肾上极见1个凸出的灰黄色肿块,大小为6.5cm×5cm×4cm,切面见其在肾实质内,呈灰红、黄相间之点彩状,质地中等,边界尚清楚;镜下观察见肿瘤组织呈腺样、乳头或实性片状或弥漫分布,瘤细胞大小不等,圆形或多边形,胞浆丰富并嗜酸性颗粒状,核异型明显,可见核仁及分裂相,间质内血管较多,有灶性出血坏死.免疫组织化学染色呈现角蛋白(Keratin)和波形蛋白
Primary renal cell carcinoma in serum AFP positive (> 20μg / L) were rare in our hospital were treated in 1 case, are reported as follows: Female patient, aged 43 due to buttock infection associated with fever for more than ten days in 1994-09 -08 admission diagnosis and treatment. Physical examination: generally good, heart and lung, liver and spleen normal, intraperitoneal palpable masses .B ultrasound examination and CT scan found in the left middle kidney space occupying lesions, serum AFP value of 283μg / L, HBsAg (-) .There was a right nephrectomy on September 27. The liver, gallbladder, pancreas, spleen, stomach and intestine were normal during operation. Hard and protruding renal cortical mass, about 5cm × 4cm size .Nephrenia and inferior vena cava next to see the enlarged lymph nodes, the line of left nephrectomy.Pathological examination revealed a very prominent on the kidney yellowish-yellow mass , The size of 6.5cm × 5cm × 4cm, the section seen in the renal parenchyma, was reddish, yellow-colored spots, medium texture, the border is still clear; microscopic observation of tumor tissue was adenoid, papillary or solid Flake or diffuse distribution, tumor cells ranging in size, round or polygonal, cytoplasm rich and eosinophilic granular, obvious nuclear atypia, visible nucleolus and mitotic phase, interstitial blood vessels more, foci Hemorrhagic necrosis. Immunohistochemical staining showed keratin and vimentin