中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2013年
1期
14-16
,共3页
甲状腺滤泡癌样肾肿瘤%免疫表型%鉴别诊断
甲狀腺濾泡癌樣腎腫瘤%免疫錶型%鑒彆診斷
갑상선려포암양신종류%면역표형%감별진단
Thyroid follicular-like renal tumor%Immunohistochemistry%Differential diagnosis
目的 探讨甲状腺滤泡癌样肾肿瘤的临床病理特点、免疫表型和鉴别诊断.方法 患者,女,25岁.因高血压20个月,体检发现右肾占位性病变,于2011年2月28日入院.血压200/130 mm Hg(1 mm Hg=0.133 kPa),甲状腺、心肺、腹部检查均未见异常,肾区无叩击痛.血尿常规、生化常规、血儿茶酚胺类物质、甲状腺功能指标检查结果均正常.CT检查示右肾上极类圆形结节灶,边界清晰,最大截面积为2.2cm×3.0cm,密度不均,肾动脉受压下移.临床诊断为右肾肿瘤.全麻下行右肾肿瘤剜除术.术中见肿瘤位于右肾门上前内侧,边界清楚,与周围轻度粘连.手术完整剜除肿瘤组织及其包膜.术后患者血压降至正常.结果 病理检查:圆形肿物1个,直径2.5 cm,包膜完整,切面灰红灰白色,见多个小囊腔,囊内含胶冻状物.镜下:肿瘤组织排列成甲状腺滤泡样,滤泡腔内含有丰富的嗜酸性胶质.免疫组化染色:EMA、Vimtin、CK7、CK20均为阳性,CD117、TTF-1、TG、CgA、Syn均为阴性.病理诊断:甲状腺滤泡癌样肾肿瘤.术后随访1年,肿瘤无复发或转移.结论 甲状腺滤泡癌样肾肿瘤是一种十分罕见的肾上皮细胞肿瘤,目前尚未归属于任何已知的肾细胞癌亚型,提高对这一肿瘤的认识可避免误诊和不适当的治疗.
目的 探討甲狀腺濾泡癌樣腎腫瘤的臨床病理特點、免疫錶型和鑒彆診斷.方法 患者,女,25歲.因高血壓20箇月,體檢髮現右腎佔位性病變,于2011年2月28日入院.血壓200/130 mm Hg(1 mm Hg=0.133 kPa),甲狀腺、心肺、腹部檢查均未見異常,腎區無叩擊痛.血尿常規、生化常規、血兒茶酚胺類物質、甲狀腺功能指標檢查結果均正常.CT檢查示右腎上極類圓形結節竈,邊界清晰,最大截麵積為2.2cm×3.0cm,密度不均,腎動脈受壓下移.臨床診斷為右腎腫瘤.全痳下行右腎腫瘤剜除術.術中見腫瘤位于右腎門上前內側,邊界清楚,與週圍輕度粘連.手術完整剜除腫瘤組織及其包膜.術後患者血壓降至正常.結果 病理檢查:圓形腫物1箇,直徑2.5 cm,包膜完整,切麵灰紅灰白色,見多箇小囊腔,囊內含膠凍狀物.鏡下:腫瘤組織排列成甲狀腺濾泡樣,濾泡腔內含有豐富的嗜痠性膠質.免疫組化染色:EMA、Vimtin、CK7、CK20均為暘性,CD117、TTF-1、TG、CgA、Syn均為陰性.病理診斷:甲狀腺濾泡癌樣腎腫瘤.術後隨訪1年,腫瘤無複髮或轉移.結論 甲狀腺濾泡癌樣腎腫瘤是一種十分罕見的腎上皮細胞腫瘤,目前尚未歸屬于任何已知的腎細胞癌亞型,提高對這一腫瘤的認識可避免誤診和不適噹的治療.
목적 탐토갑상선려포암양신종류적림상병리특점、면역표형화감별진단.방법 환자,녀,25세.인고혈압20개월,체검발현우신점위성병변,우2011년2월28일입원.혈압200/130 mm Hg(1 mm Hg=0.133 kPa),갑상선、심폐、복부검사균미견이상,신구무고격통.혈뇨상규、생화상규、혈인다분알류물질、갑상선공능지표검사결과균정상.CT검사시우신상겁류원형결절조,변계청석,최대절면적위2.2cm×3.0cm,밀도불균,신동맥수압하이.림상진단위우신종류.전마하행우신종류완제술.술중견종류위우우신문상전내측,변계청초,여주위경도점련.수술완정완제종류조직급기포막.술후환자혈압강지정상.결과 병리검사:원형종물1개,직경2.5 cm,포막완정,절면회홍회백색,견다개소낭강,낭내함효동상물.경하:종류조직배렬성갑상선려포양,려포강내함유봉부적기산성효질.면역조화염색:EMA、Vimtin、CK7、CK20균위양성,CD117、TTF-1、TG、CgA、Syn균위음성.병리진단:갑상선려포암양신종류.술후수방1년,종류무복발혹전이.결론 갑상선려포암양신종류시일충십분한견적신상피세포종류,목전상미귀속우임하이지적신세포암아형,제고대저일종류적인식가피면오진화불괄당적치료.
Objective To investigate the features of clinical pathology,phenotye and differential diagnosis of thyroid follicular carcinoma-like renal tumor.Methods A 25-year-old female patient was hospitalized in February 28,2011 because of hypertension for 20 months.Physical examination revealed a right renal space-occupying lesions without percussion pain.Blood pressure was 200/130 mm Hg (1 mm Hg =0.133 kPa).Thyroid,heart,lung,and abdominal examination showed no abnormalities.Blood,urine routine,biochemical examination,blood catecholamines,and thyroid function test results were normal.CT examination showed that a visible circular nodules with clear boundary was in the upper pole of the right kidney,and the maximum section about 2.2 cm × 3.0 cm withuneven density andrenal artery was pressed down.Clinical diagnosis was right renal tumor,and right renal tumor was removed under general anesthesia.Intraoperative tumor was located in the right renal hilumwithclear boundary,and the surrounding mild adhesions.Postoperative blood pressure wasnormal.Results General inspection of the specimen:a 2.5 cm diametermasswith intact capsule.The color of the section of the mass is gray red and gray.Multiple small cysts are seen in the section and the cysts contain jelly material.Microscope inspection:the tumor tissue is arranged like thyroid follicular and the follicular contains much acidophil colloid.Immunohistochemistry:the tumor cell is EMA (+),Vimtin (+),CK7 (+),CK20 (+),CD117 (-),TTF-1 (-),TG (-),CgA (-),Syn (-).Conclusions Thyroid follicular carcinoma-like renal tumors is a very rare kidney epithelial cell tumor,which is attributable to any known subtypes of renal cell carcinoma.To improve the understanding of it can avoid misdiagnosis and prevent inappropriate treatment.
