摘要
目的通过分析肾脏原发性神经内分泌癌的病因、临床表现、影像学及病理学特点、相关治疗方案及预后,来增强对该病的认识。方法分析1例肾脏原发性神经内分泌癌患者的相关资料,参考国内及国外文献,对该病进行总结。结果患者主要症状为腰背部疼痛,术后大体标本:右肾内巨大肿块,大小约8 cm×7 cm×6 cm,切面灰黄、质中,浸润肾盂、肾包膜及肾周脂肪,下腔静脉查见癌栓。镜检:肿瘤细胞为小圆形或梭形,小梁状、巢状或片状排列,核分裂易见。免疫组化:CK(+)、CD10(+)、CK7(+)、CK18(+)、CD117(+)、CD56(+)、FLi-1(+)、EMA(+)、Syn(+)、CgA(+);Vimentin(-)、LCA(-)、NKX3.1(-)、CD99(-)、PSA(-);Ki-67(>20%)。术后口服索拉非尼,随访6个月未见明显进展。结论肾神经内分泌癌恶性程度高,侵袭性强,预后较差,缺乏特异性临床表现和影像学特点,确诊需要依靠组织病理和免疫组化,治疗以手术及放疗和化疗为主。
Objective To improve the understanding of renal neuroendocrine carcinoma by analyzing the pathogenesis,clinicopathological features,diagnosis,treatment and prognosis.Methods We reported one case of a patient with the renal neuroendocrine carcinoma in our hospital and review relevant literature information.Results The main symptom of the patient was low back pain.Postoperative gross specimen:a large mass in the right kidney,about 8 cm×7 cm×6 cm,in the gray smear of the cut surface,infiltrating the renal pelvis,renal capsule and perirenal fat,and seeing the tumor thrombus in the inferior vena cava.Microscopic examination:Tumor cells are small round or fusiform,trabecular,nested or flaky,with nuclear division easy to see.Immunohistochemistry:CK(+),CD10(+),CK7(+),CK18(+),CD117(+),CD56(+),FLi-1(+),EMA(+),Syn(+),CgA(+);Vimentin(-),LCA(-),NKX3.1(-),CD99(-),PSA(-);Ki-67(>20%).Sorafenib was given orally after surgery,and no significant progress was observed during the follow-up of 6 months.Conclusion Primary renal neuroendocrine carcinoma had high malignancy and poor prognosis.Due to the lack of specific features in clinical manifestation and image,pathological examination and immunohistochemistry play an important role in the diagnosis of primary renal neuroendocrine carcinoma.The major treatment included surgery,chemotherapy and radiotherapy.
作者
周鑫
宋斌
王禾
ZHOU Xin;SONG Bin;WANG He(Department of Urology,Second Affiliated Hospital,the Fourth Military Medical University,Xi′an,Shaanxi 710038,China)
出处
《热带医学杂志》
CAS
2019年第3期301-303,387,共4页
Journal of Tropical Medicine
基金
国家自然科学基金(81772745)
关键词
肾脏肿瘤
神经内分泌肿瘤
免疫组化法
Renal tumor
Neuroendocrine carcinoma
Immunohistochemistry
