肾乳头状腺瘤合并肾多发性血管平滑肌脂肪瘤1例报告附文献复习.pdfVIP

· 530· J Diagn Concepts Pract 2007，Vo1．6，No．6 · 论 著 · 肾乳头状腺瘤合并肾多发性血管平滑肌脂肪瘤 1例报告附文献复习 张秀梅， 孙 薇， 谭 进， 饶 秋， 周航波， 马恒辉， 石群立 (解放军南京军区南京总医院病理科，江苏 南京 210002) 【摘要】 目的：探讨肾乳头状腺瘤(RPA)合并多发性肾血管平滑肌脂肪瘤(RAML)的临床病理学特征、诊断及鉴 别诊断要点。方法：应用光镜、免疫组织化学检测对 l例RPA合并多发性RAML标本进行观察。结果：肾内肿瘤包括 以梭形细胞为主的RAML与一境界清楚的RPA：免疫组化标记梭形肿瘤细胞阳性表达 HMB45、S一100、CD34，而 CK7、上皮膜抗原(EMA)、波形蛋白(vimentin，Vim)和结蛋白(desmin，Des)表达呈阴性。RPA细胞呈立方状或柱状， 其细胞阳性表达CK7、CD10和EMA，而HMB45、S一100、Vim、结蛋白则呈阴性。结论：RPA合并多发性RAML极罕见， 其组织起源目前仍有争议，其诊断及鉴别诊断主要依靠组织病理学、免疫组织化学检查。 关键词：肾脏； 乳头状腺瘤； 血管平滑肌脂肪瘤 中图分类号：R737．1l 文献标识码：A 文章编号：167l一2870(2007)06-0530—03 Papillary adenoma accompanied with multiple angiomyolipoma in the kidney： a case report and review of the literature ZHANG Xiu—mei，SUN Wei，TAN Jin，RA0 Qiu，ZHOU Hang-bo，MA Heng-hui,SHI Qun—li．Department of Pothology,Nanjing General Hospital ofPLA，Jiangsu Province，Nanjing 210002，China 【Abstract】 Objective To investigate the clinicopathol0gic features and differential diagnosis of papillary adenoma with angiomyolipoma in the kidney． Methods A papillary adenoma with angiomyolipoma in the kidney in a female case was investigated pathologically by light microscopy and immunohistochemical stains． Results The patient complained of pain in the right flank and hematuria． Histologically， the tumor exhibited features of typical angiomyolipoma and well— defined papillary adenoma．The spindle cells were positive of HMB45，S-100，CD34，and negative of CK7，EMA，vimentin and desmin determined by immunohistochemical staining． Papillary adenoma was positive of CK7， EMA， CD10， and negative of HMB45， S一100， vimentin and desmin． Conclusions The papillary adenoma with angiomyolipoma in the kid