摘要
目的探讨泌尿系肾源性腺瘤的临床病理特征,提高对该病的认识。方法回顾性分析2016年1月至2020年12月术后经病理证实的6例泌尿系肾源性腺瘤患者的临床病理资料。结果入组患者均为男性,年龄为24~70岁,中位年龄54.5岁。以肉眼血尿为首发症状2例,下尿路症状2例,体检发现左肾占位1例,1例因双肾积水行肾穿刺造瘘发现。病程为7天~1年余。位于膀胱、前列腺、输尿管分别为4例、1例、1例。影像学表现无明显特异性。所有患者均行手术治疗。术后病理示:肿瘤直径范围0.2~1.0 cm,镜下见肿瘤细胞呈单层排列,核圆或类圆形,核仁及核分裂象罕见;免疫组化示:PAX-8、PAX-2阳性表达均为4例,CK7阳性表达3例,P504S阳性表达1例,GATA3、p63阴性表达均为4例,PSA阴性表达3例,Ki-67增殖指数1%~3%。随访2~48个月,5例存活者均未见转移及复发。结论肾源性腺瘤是一种罕见的良性病变,可发生于泌尿道各部位,男性发病率高,临床及影像学表现无特异性,术前诊断困难且易误诊,确诊依赖于病理及免疫组化检查,手术为其主要治疗方式,术后应长期随访。
Objective To analyze the clinicopathological characteristics of nephrogenicadenoma in the urinary to improve the understanding of the disease.Methods A retrospective analysis was done on 6 patients with nephrogenic adenomas confirmed by pathology from January 2016 to December 2020.Results The enrolled patients were all males,ranging in age from 24 to 70 years old,with a median age of 54.5 years old.Gross hematuria was the first symptom in 2 cases,lower urinary tract symptoms in 2 cases,physical examination revealed 1 case of left kidney space,1 case of renal puncture fistula due to hydronephrosis,and the course of the disease lasted from 7 days to more than 1 year.There were 4 cases,1 case,and 1 case located in the bladder,prostate,and ureter,respectively.The imaging features has no obvious specificity.All patients underwent surgical treatment.Postoperative pathology showed that the tumor diameter ranged from 0.2 to 1.0 cm.The tumor cells were arranged in a single layer under the microscope,with round or round nuclei,rare nucleoli and mitotic figures.Immunohistochemistry showed that there were 4 cases with PAX-8,PAX-2 positive,3 cases were positive for CK7,1 case was positive for P504S,4 cases were negative for GATA3 and p63,3 cases were negative for PSA,and the Ki-67 proliferation index was 1%to 3%.During a follow-up of 2 to 48 months,none of the 5 survivors had metastasis or recurrence.Conclusion Nephrogenic adenoma is a rare benign lesion that can occur in various parts of the urinary tract.The incidence rate in male is higher.The clinical and imaging findings are not specific.Preoperative diagnosis is difficult and easy to misdiagnose.The diagnosis depends on pathology and immunohistochemistry.Surgery is the main treatment method,and long-term follow-up is required after surgery.
作者
张涛
冯莉娟
张开能
冯文博
殷思范
柯昌兴
ZHANG Tao;FENG Lijuan;ZHANG Kaineng;FENG Wenbo;YIN Sifan;KE Changxing(Department of Urology,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)
出处
《临床肿瘤学杂志》
CAS
2021年第11期1016-1019,共4页
Chinese Clinical Oncology
基金
云南省科技厅科技计划资助项目[2018FE001(-048)]。
关键词
肾源性腺瘤
临床病理特征
诊断
Nephrogenic adenoma
Clinicopathological characteristics
Diagnosis
