摘要
目的研究囊性肾瘤的临床特点、病理学形态、免疫表型和鉴别诊断。方法收集我院2006-2013年经病理确诊的囊性肾瘤20例,总结与分析其临床特点、组织学形态及免疫组化表达情况,并探讨其鉴别诊断。结果囊性肾瘤男性略多于女性,平均年龄52岁,临床症状多为体检发现肾肿物。影像学(B超、CT、MRI)方法提示肾囊性占位性病变。肿物多累及肾左侧,位于中下极者略多,最大径平均值为3.0 cm。肿瘤以手术切除为主,其中后腹腔镜下肾根治性切除术7例,肾部分切除术6例,保留肾单位肾肿瘤剜除术5例,肾囊肿去顶减压术2例。大体为囊性肿物,镜下囊壁衬附扁平、立方或鞋钉样上皮细胞。间隔多为纤维组织样。免疫组化染色显示:上皮细胞阳性例数/总例数为细胞角蛋白(cytokeratin,CK)(7/7)、CK7(2/3)、CK19(1/1)、CD10(1/7),间质细胞阳性例数/总例数为孕激素受体(3/3)、雌激素受体(2/3)、CD10(1/7)。结论囊性肾瘤是发生于肾的罕见的良性囊性肿瘤。其临床表现无特异性。影像学检查是发现本病的常用手段,病理学检查是确诊本病的金标准。本病应与多房囊性肾细胞癌和部分囊状分化的肾母细胞瘤鉴别。其治疗以手术切除为主。
Objective To study the clinical features, pathological morphology, immune phenotypes and differential diagnosis of cystic nephroma. Methods Twenty cystic nephroma patients admitted to our hospital from 2006 to 2013 were included in this study. The clinical features, pathological morphology, immune phenotype and differential diagnosis of cystic nephroma were analyzed. Results The incidence of cystic nephroma was higher in male patients than in female patients with an average age of 52 years. Their clinical symptoms were usually found in physical examination. B-type ultrasound, CT and MRI showed that cystic nephroma was an occupying lesion in kidney with left kidney involved. The tumor was frequently located in the lower pole with a maximum average diameter of 3.0 cm and usually surgically removed. Of the 20 cystic nephroma patients, 7 underwent radical nephrectomy, 6 underwent partial nephrectomy, 5 received enuleation with nephron preserved, and 2 received decompression. Flat, cubic or hobnail epithelial cells were found in the cystic lining under microscope. Fibrous tissue was observed in the tumor septum. Immunohistochemistry staining showed CK（7/7）, CK7（2/3）, CK19（1/1）, CD10（1/7）, and PR（3/3）, ER（2/3）, CD10（1/7）. Conclusion Cystic nephroma is a rare and benign cystic tumor in kidney with no specific clinical manifestations. B-type ultrasound, CT and MRI are the most commonly used accessory tools for its diagnosis. Pathology is the gold standard for its diagnosis. Cystic nephroma should be differentially diagnosed from partially differentiated cystic nephroblastoma and cystic renal cell carcinoma. Cystic nephroma is usually surgically removed.
出处
《解放军医学院学报》
CAS
2014年第7期710-712,共3页
Academic Journal of Chinese PLA Medical School
关键词
囊性肾瘤
病理学特点
诊断
鉴别
cystic nephroma
pathological features
diagnosis, differential
