后肾腺瘤临床病理及免疫组化观察分析.docVIP

后肾腺瘤临床病理及免疫组化观察分析 孙慧勤作者简介: 孙慧勤,女，云南省昆明市人，博士，副教授, 副主任医师，主要从事肿瘤病理学及血管生成方面的研究。电话: (023 E-mail: 作者简介: 孙慧勤,女，云南省昆明市人，博士，副教授, 副主任医师，主要从事肿瘤病理学及血管生成方面的研究。电话: (023 E-mail: huiqinsun02@ 收稿日期：2008-03-03 ；修回日期 摘 要：目的 探讨后肾腺瘤的临床病理、免疫组化特征及鉴别诊断。方法　应用常规病理、免疫组化方法观察本所近年诊断的两例后肾腺瘤手术切除标本，结合相关临床资料（从病史中摘取）及文献复习，分析后肾腺瘤的临床病理和免疫组化特点。结果　两例大体均为类圆形灰白色肿块，大小各约1、4CM，有薄层包膜，与周围组织分界清。组织学上具有独特的形态结构特点：瘤细胞较小，核大浆少，无异型性，呈规则的小管、小团状及肾小球样等结构排列。免疫组化：vimentin阳性，WT1阳性或部分阳性，CK灶性阳性， CD57一例散在和小灶性阳性，另一例片状强阳性，EMA、CK7、CgA、CD10阴性。两例均发生于中老年女性，其中一例在同一肾脏的另一部位还有肾细胞癌。结论　后肾腺瘤是WHO 新确定的一类少见的良性肿瘤，在形态学上具有独特的组织结构特点，免疫表型为WT1、CD57、vimentin、CK多有表达，其中vimentin恒定出现，WT1、CD57、CK表达强度和范围各有不同，而EMA，CK7，CgA、CD10多无表达,要注意与Wlims 瘤、肾乳头状细胞癌、后肾腺纤维瘤等进行鉴别。 关键词：后肾腺瘤　临床病理　免疫组化表型特征 中图法分类号: 文献标识码: The clinicopathologic and immunohistochemical features of metanephric adenoma Sun Huiqin, Guo Deyu, Zhang Rong, ZhaoYouguang,Yan Xiaochu, Yu Dongmei, Liu Fengxian (Institute of Pathology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China) Abstract: Objective to study the clinicopathologic, immunohistochemical features and differential diagnosis of metanephric adenoma (MA). Methods 2 cases of MA recently diagnosed in our institute were been observed and analyzed in the gross, histology and immunohistochemical feature , clinical information was extracted from the medical records, as the same time review of the literature. Results Both tumors showed round shape and gray white mass with a clear dividing boundary line in macroscopic view. They also had distinct structure in histology as small cells with high ratios of nucleus to cytoplasm, no nuclear atypia or mitotic figures were seen. The tumor exhibited well-organized tubules, small cell nests, glomeruloid bodies, and sharply demarcated from the adjacent renal parenchyma. Immunohistochemical phenotype of expression profiles were as diffused vimentin, diffused or partially positive WT1, focalized CK, spotty or small focal of CD57