多房囊性肾细胞癌6例临床病理分析

目的：探讨多房囊性肾细胞癌（MCRCC）的临床病理特征、诊断及鉴别诊断。方法共纳入6例MCRCC 患者，其中男4例，女2例，采集其病理标本，进行临床病理分析，包括大体观、光镜观察及免疫组化标记，并复习相关文献。结果患者多无特征性的临床症状和体征，影像学多表现为边界清楚的多房性肿块，有时可见囊壁钙化。大体观：肿瘤中心位于肾皮质，边界清，囊壁直径大小不等，内涵浆液和透明液体。光镜观察：肿瘤囊内壁被覆薄层透明细胞，胞浆丰富，透明，核小（Fuhrman 核级多为 I 级），囊壁中可见腺泡状透明细胞巢，其中可见出血、含铁血黄素沉积及慢性炎症。免疫组化：透明细胞 Ckpan、Vim、CD10及 RCC均阳性，CD68阴性，Ki-67低表达。结论 MCRCC 是一种预后极好的恶性肿瘤，其病理表现易与透明细胞癌囊性变、囊性肾瘤、单纯性囊肿、多囊肾混淆。

Clinical Pathological Analysis of 6 Cases of Multilocular Cystic Renal Cell Carcinoma

Objective To explore the clinical pathological features,diagnosis and differential diagnosis of multi-locular cystic renal cell carcinoma(MCRCC). Methods Six cases of MCRCC which including 4 males and 2 fe-males were collected in our study,the clinical pathological characteristics was observed by general,light microscopy and immunohistochemical method,the related literature was also reviewed. Results Most of the patients had no characteristic clinical symptoms or signs. The main imaging findings revealed a well-demarcated multicystic mass without expansile solid nodules in the thin septa. General observation:tumor center was located in the renal cortex, borders clear,different thecal sac diameter sizes,connotation of slurry and transparent liquid. Light microscopic ob-servation:tumor capsule wall covered a thin layer of clear cell,abundant cytoplasm,transparent,nuclear small(Fuhr-man nuclear grade I). Capsule gland bubble clear cell nested in the wall,including bleeding,hemosiderin deposition and chronic inflammation. Immunohistochemical performance:clear cell Ckpan,Vim,CD10 and RCC were positive, CD68 negative,Ki-67 lower expression. Conclusion MCRCC is an excellent prognosis of malignant tumor,and its pathological manifestations are easy to be confused with clear cell carcinoma cystic change,cystic nephroma confus-ed,simple cysts and polycystic kidney.