| 张玲,李理,汪芸,等.嗜酸细胞性乳头状肾细胞癌 1例和肾嗜酸细胞瘤 1例病理鉴别并文献复习[J].安徽医药,2025,29(12):2404-2407. |
| 嗜酸细胞性乳头状肾细胞癌 1例和肾嗜酸细胞瘤 1例病理鉴别并文献复习 |
| Pathological differentiation and literature review of one case of oncocytic papillary renal cell carcinoma and one case of renal oncocytoma |
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| DOI：10.3969/j.issn.1009-6469.2025.12.015 |
| 中文关键词: 肾肿瘤 乳头状肾细胞癌 肾嗜酸细胞瘤 免疫表型 鉴别诊断 |
| 英文关键词: Kidney neoplasms Papillary renal cell carcinoma Renal oncocytoma Immunophenotype Differential diagnosis |
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| 中文摘要: |
| 目的探讨嗜酸细胞性乳头状肾细胞癌( OPRCC)和肾嗜酸细胞瘤( RO)的临床病理特点、免疫表型、诊断及鉴别诊断。方法回顾性分析中国中医科学院广安门医院 2020年 6月收治的 1例 OPRCC和 2020年 7月收治的 1例 RO的临床病理特征、免疫表型、鉴别诊断及文献复习。结果 1例 OPRCC为老年男性， 62岁， 1例 RO为老年女性， 73岁。两者肉眼观均界限清楚，切面黄褐色。镜检: OPRCC肿瘤以弥漫实性结构为主，多呈致密实片状或腺泡状、裂隙样结构，可见局灶性发育不全的乳头状结构，呈浸润性生长；瘤细胞体积偏大，胞质强嗜酸性、颗粒状，核圆形或不规则，核仁明显， Furhman核分级为 2~3级，核分裂像罕见；免疫表型波形蛋白、肾细胞癌( RCC)、 α-甲基酰基辅酶 A消旋酶(AMACR)、细胞角蛋白( 8/18)(CK8/18)、共同的急性淋巴母细胞白血病抗原( CD10)弥漫阳性，孕激素受体( PR)、肥大细胞生长因子( CD117)、细胞角蛋白 7(CK7)阴性。 RO瘤细胞排列呈实性、管状和微囊状，瘤细胞体积大，胞质丰富、嗜酸性颗粒状，间质水肿，可见透明细胞；免疫表型 RCC、波形蛋白、 AMACR、PR、CD10阴性， CD117阳性。结论具有实体结构的 OPRCC形态学上与 RO有较多重叠，两者鉴别困难，主要借助免疫表型和分子检测等辅助诊断。 |
| 英文摘要: |
| Objective To explore the clinicopathological characteristics, immunophenotype, diagnosis, and differential diagnosis ofoncocytic papillary renal cell carcinoma (OPRCC)and renal oncocytoma (RO).Methods A retrospective analysis was conducted on theclinicopathological features, immunophenotype, differential diagnosis, and literature review of one case of OPRCC admitted in June2020 and one case of RO admitted in July 2020 at Guang'anmen Hospital, China Academy of Chinese Medical Sciences.Results The case of OPRCC was an old man aged 62 years, while the case of RO was an old women aged 73 years.Both specimens were well-demar-cated on gross examination and showed yellowish-tan cut surfaces. Microscopically, the OPRCC was mainly of diffuse solid structures, most of which were compact or acinar, fissure-like structures. Focally dysplastic papillary structures with invasive growth patterns wereobserved. The tumor cells were large. The cytoplasm was strongly eosinophilic and rich in granules. Round or irregular nuclei and prom-inent nucleoli could be seen. Furhman nuclear grade ranged from 2 to 3. None or very few mitotic figures were observed.Immunohisto-chemistry (IHC) staining showed diffuse strong positivity for vimentin, renal cell carcinoma (RCC), Alpha-methylacyl-CoA racemase (AMACR), cytokeratin 8/18 (CK8/18), and common acute lymphoblastic leukemia antigen (CD10), but progesterone receptor (PR), mastcell growth factor (CD117) and Cytokeratin 7 (CK7) were negative. RO was arranged solid,tubular and microcapsule. The tumor cellswere large, with abundant eosinophilic granular cytoplasm. The stroma was edematous, and clear cells were observed. IHC stainingshowed that RCC,vimentin,AMACR,PR,CD10 were negative, but CD117 was positive.Conclusions OPRCC with solid structure pos-sesses overlapping histological features with RO and it is difficult to distinguish the two. The diagnosis is mainly assisted by immuno-phenotype and molecular detection. |
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