肾转移性多形性腺瘤临床病理观察

发布时间：2018-04-16 22:39

本文选题：肾 + 转移性多形性腺瘤　；参考：《诊断病理学杂志》2014年08期

【摘要】：目的探讨肾转移性多形性腺瘤的临床病理特征、发病及转移机制、免疫表型及诊断与鉴别诊断。方法对1例肾转移性多形性腺瘤的临床表现、大体及组织学特征、免疫组化等进行观察,并复习文献。结果患者男性,70岁。体检发现右肾肿瘤10天,行腹腔镜下右肾根治性切除术。大体为一个位于右肾下极界限清楚的实性肿物,灰白色,分叶状。镜下肿瘤呈典型的涎腺多形性腺瘤的形态学特征,结构呈多形性,肿瘤性上皮和间质混合存在,上皮和肌上皮成团及片状埋于软骨黏液样基质中,并散在分布成熟的鳞状上皮细胞巢。免疫组化示肿瘤细胞CKpan、vimentin、p16和β-catenin(+),calponin、CD10和S-100部分(+),p63弱(+),CK14(-)。结论肾转移性多形性腺瘤是一种罕见的恶性肿瘤,诊断需要有明确的病史,并且需与多形性腺瘤中的癌、癌肉瘤及肾黏液样小管状和梭形细胞癌等鉴别。
[Abstract]:Objective to investigate the clinicopathological features, pathogenesis, immunophenotype, diagnosis and differential diagnosis of renal metastatic pleomorphic adenoma.Methods A case of renal metastatic pleomorphic adenoma was reviewed.Results the male patient was 70 years old.The right renal tumor was found by physical examination for 10 days and underwent laparoscopic radical resection of the right kidney.Generally a solid mass, gray and lobular, at the lower pole of the right kidney.Under microscope, the tumor was characterized by typical morphologic features of pleomorphic adenoma of salivary gland, and its structure was pleomorphic. The neoplastic epithelium and mesenchymal epithelium were mixed, epithelium and myoepithelium were clustered and lamellar embedded in chondromyxoid matrix.And scattered in the nests of mature squamous epithelial cells.Immunohistochemistry showed that the tumor cell lines CKpanella vimentinus p16 and 尾 -catenin (CD10 and S-100) were weak (P < 0.05).Conclusion Renal metastatic pleomorphic adenoma is a rare malignant tumor. The diagnosis needs a clear history and should be distinguished from the carcinoma, sarcoma and mucoid tubular and spindle cell carcinoma in the pleomorphic adenoma.
【作者单位】：济宁医学院附属医院病理科;济宁医学院附属医院心外科;
【分类号】：R739.8

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