肾黏液样小管状和梭形细胞癌临床病理分析
| 作者: |
1张梅,
2孙琦,
2王益华,
2李志文,
2周强
1 南京市浦口区中心医院病理科, 南京 211800 2 南京大学医学院附属鼓楼医院病理科, 南京 210008 |
| 通讯: | |
| DOI: | 10.3978/j.issn.2095-6959.2013.04.008 |
摘要
目的: 探讨肾黏液样小管状和梭形细胞癌(mucinous tubular and spindle cell carcinoma,MTSCC)的临床病理学特征、诊断和鉴别诊断,提高对MTSCC的认识和诊断水平。方法: 对2例MTSCC标本进行临床病理分析,并复习相关文献。结果: 肿瘤与周围肾组织分界清楚, 肿瘤由紧密排列的、小而狭长的小管构成,小管间为淡染的黏液样间质。肿瘤细胞呈立方形和梭形,肿瘤细胞胞质嗜酸性,细胞核圆形或卵圆形,异型性小,核仁不明显,核分裂像少见,在黏液性间质中可见散在淋巴细胞、浆细胞。免疫组织化学显示2例均表达细胞角蛋白(cytokeratin,CK)7,CK18,CK8/18和波形蛋白,Ki-67增殖指数<5%。结论: MTSCC是一种较罕见的低度恶性肿瘤,具有独特的组织学和免疫组织化学特征,明确该肿瘤的形态学特征、诊断和鉴别诊断有重要意义。
关键词：
肾肿瘤
黏液样小管状和梭形细胞癌
免疫组织化学
Clinicopathologic analysis of mucinous tubular and spindle cell carcinoma of kidney
DOI: 10.3978/j.issn.2095-6959.2013.04.008
Abstract
Objective: To study the clinicopathologic features, diagnosis and differential diagnosis of mucinous tubular and spindle cell carcinoma (MTSCC) and to improve the recognition and diagnostic ability for MTSCC. Methods: Two patients with MTSCC of the kidney were retrospectively analyzed and relevant literatures were reviewed. Results: The tumors were histologically well-demarcated, composed of tightly packed, small and elongated tubular with pale mucinous stroma between tubules. The tumor cells were cube and spindle and displayed eosinophilic cytoplasm. The nucleus was round or oval and subtle atypia with indistinct nucleoli and rare mitosis. Scattered lymphocytes and plasmocytes were seen within the mucinous stroma. Immunohistochemically, cytokeratin 7(CK7), CK18, CK8/18 and vimentin were positive in the tumor cells; the label index of Ki-67 was less than 5%. Conclusion: MTSCC is a rare and low-grade malignant tumor of the kidney with indistinct histology and immunohistochemical type. It is helpful for the diagnosis and differential diagnosis of MTSCC when the histologic features are identified.