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文献少有报告肾细胞癌皮肤转移.作者报告9例肾细胞癌皮肤转移的病人,并分析其组织病理学特征.作者回顾132例肾细胞癌病人中有9例皮肤转移,其中男7例,女2例,中位年龄69.3岁(55～82岁).皮肤转移在胸部者4例,头皮者2例和侧腹壁者1例.发现转移病变先于肾肿瘤者6例.确诊肾肿瘤后发现转移病变者3例.发现肾肿瘤后病人皮肤转移发生在10～28月.皮肤病变为平均直径3.2cm的皮内结节,界清、质软,呈红色、粉红色或肉色,皮下结节多发者2例.用免疫组织化学的方法,重点对最初未发现原发肿瘤的病人,观察其肿瘤细胞的特性.应用四种主要抗体(DACO),上皮膜抗原(EMA)、弹性蛋白(vimentin)、角蛋白(keratin)和癌胚抗原(CEA)分别稀释为1:100、1:100、1:400和1:400.结果:全部病人均行皮肤结节广泛切除术,均在皮肤转移3年内(中位时间22.1月)死亡.死于无关疾病(心肌梗塞)仅1例.组织学所见:光学镜检示肿瘤细胞形成蜂窝状或腺样结构,由纤维隔围绕.癌巢主要由胞质透明的大细胞构成,其基质为纤维,血
The literature rarely reports on the metastasis of renal cell carcinoma, the authors report 9 cases of renal cell carcinoma of the skin metastasis of patients and analyze the histopathological characteristics of the author’s review of 132 cases of renal cell carcinoma in 9 cases of skin metastasis, including 7 males, Female 2 cases, the median age of 69.3 years old (55 to 82 years old) .The skin metastasis in the chest in 4 cases, 2 cases of scalp and lateral abdominal wall in 1.Extracted metastatic lesions in renal tumors in 6 cases.After diagnosis of renal tumors 3 cases of metastatic lesions were found, and found that the skin metastasis of patients with renal tumors occurred in 10 to 28 months.The skin lesions were intradermal nodules with an average diameter of 3.2 cm, clear, soft, red, pink or flesh color, subcutaneous Day of multiple hair in 2 cases.Using immunohistochemical methods, focusing on the initial primary tumor was observed in patients with the characteristics of the tumor cells.Using four major antibodies (DACO), epithelial membrane antigen (EMA), elastin ( vimentin, keratin and carcinoembryonic antigen (CEA) were diluted to 1: 100, 1: 100, 1: 400 and 1: 400.Results: All patients underwent extensive resection of skin nodules, Metastasis within 3 years (median time 22.1 months) died of an unrelated disease (myocardial infarction) in only 1. Histological findings: light Microscopic examination shows the tumor cells form a honeycomb structure or adenoid, surrounded by fibrous septa. Nests mainly composed of large transparent cytoplasm, which is a fiber matrix, blood