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目的报告1例肾脏混合性上皮间质肿瘤患者的临床及病理特点。方法患者女性,50岁。有20年口服避孕药史。主诉腰部不适和血尿半年,CT及MRI示左肾上极囊实性8cm×6cm肿物,术前诊断囊性肾癌,2004年7月行左肾根治性切除术。结果术中发现左肾上极与周围组织严重粘连。术后见左肾上极7.9cm×8.9cm×9.0cm多房囊性肿瘤,边界清楚,内充满咖啡色粘稠液体,囊腔直径0.5~2.0cm,部分囊壁较厚呈实性。病理检查:肿瘤均由上皮和间质成分共同构成,上皮细胞呈立方状、柱状和靴钉样,可见明确的胃肠道上皮分化细胞。间质成分主要由梭形细胞构成,可见特征性呈束状分布的平滑肌组织。免疫组化:上皮细胞AE1/AE3(+),间质细胞ER(+)、PR(+)、SMA(+)。术后随访8个月未见复发。结论肾脏混合性上皮间质肿瘤为良性肿瘤,罕有胃肠道上皮分化特征,需与肾脏其他良恶性肿瘤鉴别。
Objective To report the clinical and pathological features of 1 patient with mixed renal interstitial neoplasm. Methods Female patient, 50 years old. 20 years history of oral contraceptives. Chief complaint lumbar discomfort and hematuria for six months, CT and MRI showed the left renal upper pole real 8cm × 6cm tumor, preoperative diagnosis of cystic renal cell carcinoma, in July 2004 underwent radical nephrectomy. Results Intraoperative findings of the upper left kidney and surrounding tissue severe adhesions. After surgery, see the left kidney on the very side of 7.9cm 8.9x 9.0cm multiple cystic tumors, the border is clear, filled with brown viscous liquid, cyst diameter 0.5 ~ 2.0cm, part of the thick wall was solid. Pathological examination: the tumor is composed of epithelial and interstitial components together, the epithelial cells were cubic, columnar and nails-like, visible gastrointestinal epithelial differentiated cells. Interstitial components are mainly composed of spindle cells, showing a characteristic bundle-like distribution of smooth muscle tissue. Immunohistochemistry: epithelial cells AE1 / AE3 (+), interstitial cells ER (+), PR (+), SMA (+). No follow-up 8 months follow-up. Conclusions Kidney mixed epithelial mesenchymal tumor is a benign tumor with rare gastrointestinal epithelial differentiation. It needs to be differentiated from other benign and malignant tumors in the kidney.