肾乳头状腺瘤合并肾多发性血管平滑肌脂肪瘤1例报告附文献复习

目的:探讨肾乳头状腺瘤(RPA)合并多发性肾血管平滑肌脂肪瘤(RAML)的临床病理学特征、诊断及鉴别诊断要点。方法:应用光镜、免疫组织化学检测对1例RPA合并多发性RAML标本进行观察。结果:肾内肿瘤包括以梭形细胞为主的RAML与一境界清楚的RPA;免疫组化标记梭形肿瘤细胞阳性表达HMB45、S-100、CD34,而CK7、上皮膜抗原(EMA)、波形蛋白(vimentin,Vim)和结蛋白(desmin,Des)表达呈阴性。RPA细胞呈立方状或柱状,其细胞阳性表达CK7、CD10和EMA,而HMB45、S-100、Vim、结蛋白则呈阴性。结论:RPA合并多发性RAML极罕见,其组织起源目前仍有争议,其诊断及鉴别诊断主要依靠组织病理学、免疫组织化学检查。

Papillary adenoma accompanied with multiple angiomyolipoma in the kidney: a case report and review of the literature

Objective To investigate the clinicopathologic features and differential diagnosis of papillary adenoma with angiomyolipoma in the kidney.Methods A papillary adenoma with angiomyolipoma in the kidney in a female case was investigated pathologically by light microscopy and immunohistochemical stains.Results The patient complained of pain in the right flank and hematuria.Histologically,the tumor exhibited features of typical angiomyolipoma and well-defined papillary adenoma.The spindle cells were positive of HMB45,S-100,CD34,and negative of CK7,EMA,vimentin and desmin determined by immunohistochemical staining.Papillary adenoma was positive of CK7,EMA,CD10,and negative of HMB45,S-100,vimentin and desmin.Conclusions The papillary adenoma with angiomyolipoma in the kidney is a rare renal neoplasm and its pathogenesis is controversial.The diagnosis and differential diagnosis mainly relies on histopathology and immunohistochemistry.