左肾黏液样小管状和梭形细胞癌1例并文献复习

摘要

目的:探讨肾黏液样小管状和梭形细胞癌患者的临床病理特征、治疗方法、疗效评价及预后.方法:回顾性分析我们收治的1例左肾黏液样小管状和梭形细胞癌患者的临床病理资料,并复习相关文献.患者女,54岁.因左侧腰部疼痛就诊,CT检查提示左肾下极见大小约44 mm×37 mm×31 mm团块样影.结果:行左肾部分切除术,术后病理诊断:左肾黏液样小管状和梭形细胞癌.免疫组化:肿瘤细胞P－CK(+),EMA(+),CD68(PGM1)(－),CK7(+),CAM5.2(－),PAX－8(+),CK20(－),Inhibin－a(－),RCC(－),Vim-entin(+),CD10(－).术后患者恢复良好,康复出院,随访至今未见复发及转移.结论:肾黏液样小管状和梭形细胞癌是一类罕见的肾细胞癌,恶性程度相对较低,预后相对较好,治疗方法目前主张手术治疗,但术后仍需注意规律随访.%Objective:To discuss the clinicopathological feature,treatment,curative effect and prognosis of patients with mucinous tubular and spindle cell carcinoma of kidney.Methods:Go over and analyze a patient with mucinous tubular and spindle cell carcinoma of kidney,along with the review of relevant bibliography.The patient is a woman,at the age of 54,who came to hospital for a pain in her waist on the left side.Through CT,it was found that there was a mass of opacity on her left kidney,about 44 mm×37 mm×31 mm.Results:Part of her left kidney has been re-moved and got through a pathological diagnosis after operation:Mucinous tubular and spindle cell carcinoma of left kidney.Immunohistochemistry:Tumor cells P － CK(+),EMA(+),CD68(PGM1)(－),CK7(+),CAM5.2(－),PAX－8(+),CK20(－),Inhibin－a(－),RCC(－),Vimentin(+),CD10(－).The patient has gone well after operation and was discharged from hospital upon recovery.There is no recrudescence and the shift problem so far.Conclusion:Mucinous tubular and spindle cell carcinoma of kidney belongs to a rare kind of renal cell carcino-ma,which has comparatively low degree of malignancy and good prognosis.Surgery is a preferred treatment by far,but a regular visit is necessary after operation.