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目的:探讨肾嫌色细胞癌的临床诊断和治疗方法。方法:3例肾嫌色细胞癌均经手术切除及光镜、免疫组化、Hale’s胶体铁染色和电镜检查。结果:Doppler超声和CT检查无特异性。病理组织学:肉眼观察肿瘤质地均一,呈淡棕色,肿瘤中央可有坏死灶;光镜下细胞大,胞浆呈纤细网状结构,胞界清楚;Hale`s胶体铁染色阳性;EMA、CK19、Ckpan、Vimentin阳性,S-100阴性;电镜下胞浆内有大量膜性小囊泡。随访14.1～31个月(平均19.7个月),1例术后11个月肺部转移,2例无复发或转移,至今生存。结论:肾嫌色细胞癌在病理组织学、组织化学、免疫组化和电镜观察与其它肾癌有明显区别。手术切除是治疗首选方法。可能是一种低恶性潜能有较好预后的肿瘤。
Objective: To investigate the clinical diagnosis and treatment of chromophobe renal cell carcinoma. Methods: Three cases of chromophobe renal cell carcinoma were resected and examined by light microscopy, immunohistochemistry, Hale’s colloidal iron staining and electron microscopy. Results: Doppler ultrasound and CT examination were not specific. Histopathological examination showed that the tumors were homogenized with a light brown color and showed necrotic lesions in the center of the tumor. The cells under the light microscope were large and the cytoplasm showed a fine network structure with clear cytoplasm. Hale’s colloid iron staining was positive. EMA and CK19 , Ckpan, Vimentin positive, S-100 negative; electron microscopy cytoplasm with a large number of membranous vesicles. The patients were followed up for 14.1-31 months (average 19.7 months). One patient had pulmonary metastases at 11 months after operation and no recurrence or metastasis in 2 patients. Conclusion: The chromophobe renal cell carcinoma has obvious difference in pathology, histochemistry, immunohistochemistry and electron microscope observation from other renal cell carcinoma. Surgical resection is the preferred method of treatment. It may be a better prognosis of malignant tumors.