成人肾恶性横纹肌样瘤15例临床病理及免疫表型分析

目的：探讨成人肾恶性横纹肌样瘤（MRTK）的病理组织学,分子免疫表型的特点及临床意义.方法：对我院1983～2009年收治15例肾脏恶性横纹肌样瘤的石蜡组织切片运用SP法进行免疫组化染色,检测Vi-mentin、Myoglobin、Desmin、α-SMA、EMA、NSE、S-100的表达,并结合临床病理特征进行分析.结果：组织学上瘤细胞胞界清楚.胞浆丰富具有嗜酸性颗粒、常见大的嗜酸性包涵体,呈圆形或椭圆形,将细胞核挤向一侧.核膜明显而核仁突出,核分裂多见.经SP染色后,Vimentin均警阳性或强阳性表达,EMA、NSE和S-100均有不同程度的阳性表达,α-SMA有2例呈阳性表达,而Myoglobin、Desmin均呈阴性表达.结论：成人MRTK是一种表达多种免疫抗原,独立的可多向分化的肾恶性肿瘤,Vimentin和Myoglobin、Desmin、α-SMA有助于MRTK的诊断和鉴别诊断.

Malignant Rhabdoid Tumor of the Kidney in Adults: Studies on Clinicopathological Features and Immunophenotype of Fifteen Cases

Objective： To study the clinicopathological features and immunophenotype of malignant rhabdoid tumor of the kidney in adults. Methods：15 cases of MRTK were collected from 1983 to 2009 i.n our hospital . The immunohistochemical SP method was used to detect the expression of Vimentin, Myoglobin. Desmin. a-SMA, EMA,NSE,S-100. The clinical findings were analyzed and the hematoxylin and eosin-stained sections were re- viewed. Results： The tumors with clear cell boundary were histologically characterized by the presence of intracy- toplasmic eosinophilic inclusions. The large eosinophilie inclusion bodies were round or oval that push the nucleus to one side. The cell nucleus of the tumor cell was round with clear nucleolemma and prominent nucleoli. After SP staining, Vimentin showed positive or strong positive expression, EMA.NSE and S-100 expression in various de- grees,a SMA showed positive only in 2 cases, and Myoglobin.Desmin were all negative. Conclusions： MRTK in a- dults is an independent neoplasm with considerable morphological and immunohistochemical phenotypes. Vimentin.Myoglobin,Desmin and a-SMA facilitate the diagnosis and differential diagnosis of MRTK.