嗜酸性实性和囊性肾细胞癌2例临床病理观察

目的探讨嗜酸性实性和囊性肾细胞癌的诊断及鉴别诊断。方法分析2例嗜酸性实性和囊性肾细胞癌的临床病理特征及免疫表型,并复习相关文献。结果例1肿瘤以实性区为主,局灶形成囊腔,肿瘤细胞强嗜酸性,有胞质内彩斑、空泡,可见多核化,囊壁被覆鞋钉样排列的强嗜酸性细胞。例2以囊性区(巨囊)为主,局灶实性,囊壁被覆强嗜酸性肿瘤细胞,呈鞋钉样排列,胞质内彩斑及空泡不明显。2例免疫组化表型均为局灶CK20(+)。结论嗜酸性实性和囊性肾细胞癌是新近认识的一种以实性和囊性结构及大的嗜酸性细胞为主型的惰性肾肿瘤,具有独特的病理特征,免疫表型表现为独特的CK20局灶阳性。通过其特征性的组织学形态和独特的免疫表型表现比较容易与其他嗜酸性肾细胞肿瘤鉴别。

Eosinophilic solid and cystic renal cell carcinoma:a clinicopathological analysis of two cases

Objective To investigate the diagnosis and differential diagnosis of eosinophilic solid and cystic renal cell carcinoma.Methods The clinicopathological features and immunophenotypes of 2 cases of eosinophilic solid and cystic renal cell carcinoma were analyzed and related literatures were reviewed.Results In case 1,the tumor was mainly composed of solid area,and the cystic cavity was formed focally.The tumor cells were strongly eosinophilic,with intracytoplasmic vacuoles,which were multinucleated,and the walls were covered with spike-like strong eosinophils.In case 2,the tumor was mainly composed of cystic(macrocystic)components,with focally solid area.The cystic wall was covered with strongly eosinophilic tumor cells which were arranged in a spike-like manner,and the intracytoplasmic vacuoles were not obvious.All 2 cases were focally positive for CK20.Conclusions ESC RCC is a newly recognized inert renal tumor with solid and cystic structure and numerous eosinophils.It has unique pathological features and immunophenotype.Typically,CK20 is focally positive.It is easier to distinguish ESC RCC from other eosinophilic renal cell tumors by its characteristic histological features and unique immunophenotyping.