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目的:探讨肾上皮样血管平滑肌脂肪瘤(EAML)的临床病理特征、诊断、鉴别诊断、治疗方法及预后。方法:通过观察1例肾EAML患者的临床病理学表现与免疫组化标记并复习有关文献,讨论其组织学特征及临床生物学行为。结果:CT平扫呈略高密度实性肿块,边界清楚,病灶内无明显脂肪密度;增强扫描密度相对均匀,实质期强化程度最高,排泄期密度下降较少。镜检示肿瘤细胞弥漫分布,瘤体主要成分为上皮样细胞,细胞异型性明显,大小形状不等,核大且染色明显加深,偶有多核巨细胞,核分裂像明显。免疫组化染色显示瘤细胞HMB45+,SMA+,CK-。结论:病史、体检结合影像学检查能够给我们提供重要的诊断线索,组织病理学特点结合免疫组化标记有助于该疾病的确诊,治疗方法以手术切除为主,对于预后较差的患者应按照肾细胞癌标准长期随访。
Objective: To investigate the clinicopathological features, diagnosis, differential diagnosis, treatment and prognosis of renal epithelial angiomyolipoma (EAML). Methods: The histopathological features and clinical biological behavior of one patient with renal EAML were observed by observing the clinicopathological features and immunohistochemical markers and reviewing the literature. Results: CT scan slightly higher density of solid mass, clear boundary, no obvious fat density within the lesion; Enhanced scanning density is relatively uniform, the highest level of real during the period of excretion, the decrease of density less. Microscopic examination revealed diffuse distribution of tumor cells. The main components of the tumor were epithelial-like cells. The cells showed obvious atypia, large and small shapes, large nuclei and obvious staining. Occasionally multinucleated giant cells and mitotic figures were obvious. Immunohistochemical staining showed tumor cells HMB45 +, SMA +, CK-. Conclusion: Medical history and physical examination combined with imaging examination can provide us with important diagnostic clues. Histopathological features combined with immunohistochemical markers contribute to the diagnosis of the disease. The treatment is mainly surgical resection, and should be used in patients with poor prognosis Long-term follow-up according to renal cell carcinoma standards.