CAJ | 학술논문

目的：探讨嫌色性肾细胞癌（chromophobe renal cell carcinoma ，CRCC）和嗜酸细胞瘤（oncocytoma）的临床病理学特征，提高对二者的认识和诊疗水平。方法对手术切除的5例 CRCC 和2例 Oncocytoma 进行肉眼和光镜观察、免疫组织化学染色，分析其临床病理学差异。结果 CRCC 以实体结构为主、胞质半透明或嗜酸性颗粒状、核皱缩且核周有空晕；Oncocytoma 以巢状结构为主，胞质嗜酸颗粒状、核圆形、核仁小。免疫组化染色显示两者均呈 E-cadherin 、EMA 、CK20、vim-entin 阳性；CRCC 瘤细胞 CD10和 CK7强阳性而 S-100蛋白阴性，5名患者随访8～32个月，其中1例手术12个月后由于转移死亡；Oncocytoma 瘤细胞 S-100蛋白强阳性、CD10和 CK7阴性，2名患者随访41个月，均未出现复发和转移。结论CRCC 和 oncocytoma 二者形态学各有特征，免疫表型相似，二者鉴别诊断主要在于生长方式和细胞学特征。综上所述：CRCC为惰性肿瘤，Oncocytoma 为良性肿瘤，预后较好，手术切除后极少发生复发和转移。
목적：탐토혐색성신세포암（chromophobe renal cell carcinoma ，CRCC）화기산세포류（oncocytoma）적림상병이학특정，제고대이자적인식화진료수평。방법대수술절제적5례 CRCC 화2례 Oncocytoma 진행육안화광경관찰、면역조직화학염색，분석기림상병이학차이。결과 CRCC 이실체결구위주、포질반투명혹기산성과립상、핵추축차핵주유공훈；Oncocytoma 이소상결구위주，포질기산과립상、핵원형、핵인소。면역조화염색현시량자균정 E-cadherin 、EMA 、CK20、vim-entin 양성；CRCC 류세포 CD10화 CK7강양성이 S-100단백음성，5명환자수방8～32개월，기중1례수술12개월후유우전이사망；Oncocytoma 류세포 S-100단백강양성、CD10화 CK7음성，2명환자수방41개월，균미출현복발화전이。결론CRCC 화 oncocytoma 이자형태학각유특정，면역표형상사，이자감별진단주요재우생장방식화세포학특정。종상소술：CRCC위타성종류，Oncocytoma 위량성종류，예후교호，수술절제후겁소발생복발화전이。
Objective To raise awareness or diagnosis and treatment level of chromophobe renal cell carcinoma (CRCC) and eosinophilic adenoma (oncocytoma) by investigating the clinical and pathological features of both tumors .Methods The slices from 5 cases of CRCC and 2 cases of oncocytoma underwent gross and light microscopic abservation and immunohistochemical staining .Results CRCC’s structure was often solid , the cytoplasm of tumor cells was granular and translucent or eosinophilic ,and the nuclei showed is shrinkage and perinuclear halo .Oncocytoma’ s structure was often nested ,the cytoplasm of tumor cells was eosinophilic granular ,and the nuclei is round with small nucleoli .Immunohistochemical staining showed that E-cadherin and EM A were positive in both CRCC and oncocytoma ,while CK20 and vimentin were negative in both tumors .In CRCC ,CD10 and CK7 were strongly positive ,while S-100 pro-tein was negative .In oncocytoma ,CD10 and CK7 were negative or weak positive ;while S-100 protein was strongly positive .Conclusion The two tumors have similar immunophenotype ,yet different morphological characteristics ;The main differential diagnosis between CRCC and oncocytoma is based on grow th pat-terns and cytological characteristics .