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目的探讨甲状腺滤泡癌样肾细胞癌(TLFCK)的临床病理特点、免疫表型及鉴别诊断。方法对1例TLFCK进行临床病理分析及免疫组化研究,并进行文献复习。结果肿瘤为境界清楚灰白色肿块,最大直径3 cm。镜下肿瘤周围有一层纤细的假包膜,90%区域的肿瘤细胞排列成甲状腺滤泡样,局灶实性。免疫组化:肿瘤细胞CKpan、CK19和PAX-2弥漫(+),vimentin散在(+),而TG、TTF-1、WT-1、CD10、Cg A、CD56和villin均(-)。术后随访1年半,无复发及转移。结论 TLFCK是一种罕见类型的肾癌,诊断主要依据病理学形态和免疫组化,需要与转移性甲状腺癌、神经内分泌癌、恶性畸胎瘤、上皮型肾母细胞瘤鉴别。
Objective To investigate the clinicopathological characteristics, immunophenotype and differential diagnosis of thyroid follicular carcinoma-like renal cell carcinoma (TLFCK). Methods One case of TLFCK was analyzed by clinicopathological and immunohistochemical methods and reviewed in literatures. Results The tumor was clear gray-white mass, the maximum diameter of 3 cm. Microscopic tumor around a thin pseudocapsule, 90% of the tumor cells arranged in the thyroid follicular, focal solidity. Immunohistochemistry: CKpan, CK19 and PAX-2 were diffuse (+), vimentin scattered (+), and TG, TTF-1, WT-1, CD10, CgA, CD56 and villin were both (-). After a year and a half follow-up, no recurrence and metastasis. Conclusion TLFCK is a rare type of renal cell carcinoma. The diagnosis is mainly based on pathological morphology and immunohistochemistry, and needs to be differentiated from metastatic thyroid cancer, neuroendocrine carcinoma, malignant teratoma, and epithelial type Wilms’ tumor.