嫌色性肾细胞癌与嗜酸细胞瘤的临床病理分析与比较

目的探讨嫌色性肾细胞癌(chromophobe renal cell carcinoma,CRCC)和嗜酸细胞瘤(oncocytoma)的临床病理学特征,提高对二者的认识和诊疗水平。方法对手术切除的5例CRCC和2例Oncocytoma进行肉眼和光镜观察、免疫组织化学染色,分析其临床病理学差异。结果 CRCC以实体结构为主、胞质半透明或嗜酸性颗粒状、核皱缩且核周有空晕;Oncocytoma以巢状结构为主,胞质嗜酸颗粒状、核圆形、核仁小。免疫组化染色显示两者均呈E-cadherin、EMA、CK20、vimentin阳性;CRCC瘤细胞CD10和CK7强阳性而S-100蛋白阴性,5名患者随访8~32个月,其中1例手术12个月后由于转移死亡;Oncocytoma瘤细胞S-100蛋白强阳性、CD10和CK7阴性,2名患者随访41个月,均未出现复发和转移。结论 CRCC和oncocytoma二者形态学各有特征,免疫表型相似,二者鉴别诊断主要在于生长方式和细胞学特征。综上所述:CRCC为惰性肿瘤,Oncocytoma为良性肿瘤,预后较好,手术切除后极少发生复发和转移。

Analysis and comparation of clinical pathology of renal chromophobe cell carcinoma and eosinophilic cell tumor

Objective To raise awareness or diagnosis and treatment level of chromophobe renal cell carcinoma （CRCC） and eosinophilic adenoma （oncocytoma） by investigating the clinical and pathological features of both tumors .Methods The slices from 5 cases of CRCC and 2 cases of oncocytoma underwent gross and light microscopic abservation and immunohistochemical staining .Results CRCC’s structure was often solid , the cytoplasm of tumor cells was granular and translucent or eosinophilic ,and the nuclei showed is shrinkage and perinuclear halo .Oncocytoma’ s structure was often nested ,the cytoplasm of tumor cells was eosinophilic granular ,and the nuclei is round with small nucleoli .Immunohistochemical staining showed that E-cadherin and EM A were positive in both CRCC and oncocytoma ,while CK20 and vimentin were negative in both tumors .In CRCC ,CD10 and CK7 were strongly positive ,while S-100 pro-tein was negative .In oncocytoma ,CD10 and CK7 were negative or weak positive ;while S-100 protein was strongly positive .Conclusion The two tumors have similar immunophenotype ,yet different morphological characteristics ;The main differential diagnosis between CRCC and oncocytoma is based on grow th pat-terns and cytological characteristics .