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目的探讨肾混合性上皮和间质肿瘤的病理形态学特点、诊断及鉴别诊断。方法应用光镜观察及免疫组化方法对1例男性肾混合性上皮和间质肿瘤进行临床病理分析,并复习文献。结果肿瘤由上皮和间质两种成分构成,其中上皮成分主要是形态不一的腺管样结构,部分区域可见大小不等的囊,细胞无明显异型性;另见梭形细胞围绕在腺管或囊周围构成肿瘤的间叶成分,部分呈束状排列,形似平滑肌细胞,部分呈短梭形,似纤维母细胞或肌纤维母细胞样,梭形细胞轻度异型,核分裂罕见。免疫组化:上皮细胞AE1/AE3、CK7和CK34βE12(+);梭形细胞SMA(),desmin、vimentin、ER和PR(+),CD10部分(+)。结论肾混合性上皮和间质肿瘤具有独特的组织病理学特点,预后良好,多见于女性。本例特殊之处在于患者为成年男性,且无激素类药物应用史,极为少见。该肿瘤与成人囊性肾瘤、先天性中胚层细胞肾瘤等多种肿瘤易混淆,应依据形态学特点结合免疫组化结果鉴别。
Objective To investigate the pathomorphological features, diagnosis and differential diagnosis of renal mixed epithelial and interstitial tumors. Methods A case of male renal mixed epithelial and stromal tumors was analyzed by light microscopy and immunohistochemistry. Results The tumor consisted of epithelial and interstitial components, of which the epithelial components mainly consisted of gland-like structures of varying shapes, and cysts of unequal size were visible in some areas. The cells showed no atypia; see also the spindle-shaped cells surrounding the glandular duct Or capsule formed around the capsule of the mesenchyme of the tumor components, some were arranged in a bundle, shaped like smooth muscle cells, some short fusiform, like fibroblasts or myofibroblast-like spindle cells slightly abnormal, mitotic rare. Immunohistochemistry: epithelial cells AE1 / AE3, CK7 and CK34βE12 (+); spindle cells SMA (), desmin, vimentin, ER and PR (+), CD10 part (+). Conclusions Renal mixed epithelial and stromal tumors have unique histopathological features with good prognosis and are more common in women. This case is special because the patient is an adult male, and no hormonal drug application history, is extremely rare. The tumor and adult cystic nephropathy, congenital mesoderm neoplasms and other tumors easily confused, should be based on morphological characteristics with the identification of immunohistochemical results.