嗜酸细胞乳头状肾细胞癌3例报道并文献复习

目的:探讨嗜酸细胞乳头状肾细胞癌(OPRCC)的临床病理学特点。方法:对3例OPRCC进行光镜观察、免疫组织化学标记及荧光原位杂交检测并复习相关文献。结果:3例OPRCC中,2例男性,1例女性,年龄分别为41、45、65岁。3例均为体检发现肾肿块,例1及例2肿块位于肾下极,例3位于肾中上级,与周围肾组织分界清楚,长径分别为3.0、3.5及4.5 cm,瘤细胞细胞质丰富,嗜酸性,核Fuhrman分级2~3级,瘤细胞排列呈乳头状,乳头内见泡沫细胞聚集。免疫表型3例瘤细胞vimentin、CK7、CD10、AMACR、EMA、CK均阳性,而TFE3、CD15、CD117、RCC、E-cadherin等均阴性。荧光原位杂交检测显示3例瘤细胞均有7、17号染色体扩增。结论:OPRCC是肾细胞癌的罕见亚型,免疫表型及分子遗传学与1型乳头状肾细胞癌相似。应与嗜酸细胞瘤、嫌色性肾细胞癌、Xp11.2易位肾细胞癌等相鉴别。

Oncocytic papillary renal cell carcinoma:a report of 3 cases and review of the literature

Objective:To investigate the clinicopathological characteristics of the oncocytic papillary renal cell carcinoma(OPRCC). Methods:Three cases of OPRCC were investigated by light microscopy, immunohistochemistry, fluorescence in situ hybridization (FISH),and review of the literature. Results:Among 3 cases,2 cases were male,1 case was female,and their ages were 41,45 and 65 years old,respectively. The renal masses in 3 cases were found by medical examination. The masses in 2 cases located in the low pole of the kidney,and 1 case mass located in the middle and high pole of the kidney,the surrounding boundaries between the renal tissue and tumor was clear,and the long diameter of 3 masses were 3. 0 cm,3. 5 cm and 4. 5 cm,respectively. The cytoplasm of tumor cells were plentiful and eosinophilic,the Fuhrman grades of nuclear were from 2 to 3 grade. Tumor cells arranged in papillary pattern with accumulation of foam cells in the stroma. In 3 cases of tumor cells,vimentin,CD10,AMACR,EMA and CK7 were positive,while TFE3, CD15,CD117,RCC and E-cadherin were negative. FISH test showed that the 7 and 17 chromosomes were amplified in 3 cases of tumor cells. Conclusions:OPRCC is a rarely subtype of renal cell carcinoma,and its immune phenotype and molecular genetics are similar to that of type 1 papillary renal cell carcinoma. The OPRCC should be differentiated with oncocytoma,chromophobe renal cell carcinoma, Xp11. 2 translocation of renal cell carcinoma.