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目的探讨透明细胞乳头状肾细胞癌(CCPRCC)病理学特征以及鉴别诊断。方法研究1例透明细胞乳头状肾细胞癌,观察组织病理学表现、行免疫组化染色以及遗传学检测,同时复习相关文献。结果肿瘤直径2 cm,切面实性、灰红色。镜下典型表现是肿瘤细胞囊腔内形成乳头状生长方式;瘤细胞胞质透明并且较温和,轻度异型性,细胞核Fuhrman分级为1级;间质中可见少量平滑肌细胞以及“流产型”血管。免疫组化:肿瘤PAX2、PAX8、CK7、CA-IX、HMWCKs、EMA和vimentin(+),间质成分desmin、caldesmon、SMA和actin(+)。FISH检测未发现17号染色体获得。随访8个月肿瘤无复发。结论 CCPRCC是一种少见的肾肿瘤,病理学诊断较为复杂,需要与多种病变进行鉴别。
Objective To investigate the pathological features and differential diagnosis of clear cell papillary renal cell carcinoma (CCPRCC). Methods One case of clear cell papillary renal cell carcinoma was studied. Histopathological examination, immunohistochemical staining and genetic testing were performed. At the same time, relevant literature was reviewed. Results The tumor diameter of 2 cm, section solid, gray-red. The typical microscopic appearance of the tumor cells in the cystic cavity to form papillary growth; tumor cells cytoplasm transparent and mild, mild atypia, nuclear Fuhrman grade 1; a small amount of smooth muscle cells can be seen in the stroma and “abortion-type ”Blood vessels. Immunohistochemistry: tumor PAX2, PAX8, CK7, CA-IX, HMWCKs, EMA and vimentin (+), interstitial components desmin, caldesmon, SMA and actin (+). No chromosome 17 was detected by FISH. Tumor recurrence was followed up for 8 months. Conclusion CCPRCC is a rare renal tumor. Pathological diagnosis is complicated and needs to be differentiated from many kinds of lesions.