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目的:探讨透明细胞乳头状肾细胞癌的临床及病理特征、诊断、鉴别诊断,提高对该肾细胞癌亚型的了解。方法:收集2013年8月~2016年6月我院收治的5例透明细胞乳头状肾细胞癌患者的临床资料,重新对HE染色组织切片以及免疫组织化学切片进行光镜观察,并随访。结果:5例患者中男4例,女1例。平均年龄(61.6±15.3)(42.0~82.0)岁。平均肿瘤最大径为(3.3±1.0)(2.5~5.0)cm,除1例为pT1b期外均为pT1a期。5例患者免疫组织化学均表现为角蛋白7(CK7)、波形蛋白(Vimentin)阳性,CD10(4/5)、TFE-3(4/4)阴性。随访时间(11.4±14.9)(2.0~37.0)个月,未发现肿瘤淋巴结及远处转移,病情稳定。结论:透明细胞乳头状肾细胞癌是一种低度恶性肿瘤,目前尚未有淋巴结或远处转移的相关报道,形态上需与多种具有透明细胞和乳头状结构的肾癌鉴别,诊断这一肿瘤至少需要同时满足形态学和免疫组织化学的诊断条件。
OBJECTIVE: To investigate the clinical and pathological features, diagnosis and differential diagnosis of clear cell papillary renal cell carcinoma (NPC) and to improve the understanding of this subtype of renal cell carcinoma. Methods: The clinical data of 5 patients with clear cell papillary renal cell carcinoma admitted to our hospital from August 2013 to June 2016 were retrospectively collected. The HE-stained sections and immunohistochemical sections were observed by light microscopy and followed up. Results: There were 4 males and 1 females in 5 patients. The average age (61.6 ± 15.3) (42.0 ~ 82.0) years old. The mean maximum tumor diameter was (3.3 ± 1.0) (2.5-5.0) cm, except for 1 case of pT1b stage except for pT1a stage. Immunohistochemistry in 5 patients showed positive for keratin 7 (CK7), vimentin, negative for CD10 (4/5) and TFE-3 (4/4). Follow-up time (11.4 ± 14.9) (2.0 ~ 37.0) months, no tumor lymph nodes and distant metastasis, stable condition. Conclusion: Clear cell papillary renal cell carcinoma is a kind of low grade malignant tumor. There are no reports of lymph node metastasis or distant metastasis at present. It is necessary to identify with a variety of renal carcinoma with clear cell and papillary structure. Neoplastic at least need to meet both morphological and immunohistochemical diagnostic conditions.