肾透明细胞癌伴同侧肾上腺皮质腺瘤内转移1例及文献复习

目的：探讨1例肾透明细胞癌(clear-cell renal cell carcinoma,clear-cell RCC)伴同侧肾上腺皮质腺瘤内转移的临床病理特征及转移机制。方法：观察1例肾透明细胞癌转移至同侧肾上腺皮质腺瘤的临床表现、组织学特征、免疫组织化学特点,并复习相关文献。结果：患者,男性,63岁,右季肋部不适半月余入院。术后结果显示右肾透明细胞癌。单纯性孤立性肾囊肿。右肾上腺皮质腺瘤,瘤内见转移的肾透明细胞癌、直径约3 mm。结论：肾透明细胞癌转移至同侧肾上腺皮质腺瘤是非常罕见的现象。     

双侧甲状腺转移性肾透明细胞癌1例

患者女性,56岁,因颈前无痛性肿物1个月入院。初诊:甲状腺双侧肿瘤。患者于7年前因肾癌行右肾癌切除术。查体:一般情况好,双侧甲状腺可触及一表面光滑,随吞咽上下移动的肿物;甲状腺功能正常。X线示气管向左移位。腹部(B超、彩色多普勒)超声示:甲状腺右叶内探及一4·7cm×3·2cm椭圆形低回声团块,边界清,规整,内部滋养层血管增多,血流丰富;左叶内探及一3·0cm×2·0cm的低回声区,边界欠规整,内部回声不均匀,血流较丰富呈“花环征”。SPECT示甲状腺位置正常,两叶明显肿大,形态不完整,双侧甲状腺示踪剂分布不均匀,右叶中下部见一较大示踪剂缺…     

透明细胞乳头状肾细胞癌1例

<正>患者女性,60岁,因右侧输尿管结石入院,自诉偶有右腰部酸胀感,无发热,无尿频、尿急、尿痛,无肉眼血尿;查体:心肺听诊无殊,腹软,未及包块,未及压痛、反跳痛,右肾区轻叩痛,左肾区无叩痛;腹部CT示右肾实质内见直径1. 6 cm等低密度结节影突出肾轮廓,增强后动脉期强化类似肾皮质,后期密度减低,呈相对略低密度,报告提示右肾占位,肾癌可能。行右肾部分切除术,送病理检查。     

多囊性肾透明细胞癌的病理学诊断

目的：探讨多囊性肾透明细胞癌的临床病理特点。方法：对1例多囊性肾透明细胞癌进行了免疫组化染色,并进行文献复习。结果：本例右肾肿物18年。大体见肿物由多发不等的囊腔组成。镜下囊内壁主要由单层立方或柱状上皮被覆,部分为多层并有乳头形成。瘤细胞胞质透亮,无明显异型性。癌细胞免疫表型cytokeratin、CEA和vimentin呈阳性表达。本例诊断为多囊性肾透明细胞癌。结论：多囊性肾透明细胞癌是一种罕见的肾癌病理类型。临床上主要采用根治切除术。本瘤的生物学行为属于低度恶性肿瘤。     

肾上腺皮质嗜酸细胞癌7例临床病理分析

目的 探讨7例肾上腺皮质嗜酸细胞癌临床及病理特点.方法 回顾性分析7例肾上腺皮质嗜酸细胞癌的临床特点、组织形态学特征,并复习相关文献.结果 7例肾上腺皮质癌中皮质醇增多症1例,原发性醛固酮增多症2例,无功能性4例.7例均为肾上腺超声诊断,术后病理诊断均为肾上腺皮质嗜酸细胞癌.6例进行随访,随访时间(21.7±20.6)个月,死亡3例.结论 肾上腺皮质嗜酸细胞癌罕见,诊断依据病理学及免疫表型,多为无功能性(57.1%),亦可表现内分泌功能异常(42.9%),非低恶性度肿瘤,治疗以手术为主.     

甲状腺转移性透明细胞肾细胞癌1例

患者男性,50岁,3年前无意间触及颈部前侧有一花生粒大小肿物,无其他不适.患者于2019年11月至上海市松江区中心医院检查,颈部彩超示:甲状腺右叶结节,TI-RADS 4a类.甲状腺增强CT示甲状腺右叶、左叶占位,考虑腺瘤可能.临床考虑甲状腺肿瘤收入院,行右侧甲状腺切除术,手术切除标本送病理检查.后经仔细询问,患者曾于...     

肾透明细胞癌合并集合管癌伴肉瘤样分化1例

患者女性,72岁,因"发现左上中腹部肿物1个月余,腹痛5天"入院。左侧腹部可扪及一12 cm×10 cm×5 cm大小肿物,质硬,表面欠光滑,活动性差。静脉肾盂造影示:左肾不显影及左膀胱区改变,左侧肾盂肾盏输尿管无显影。CT检查示:左肾巨大占位囊实性病变,考虑肾癌可能性大。患者于全麻下实行左肾根治性切除术。     

转移性透明细胞性肾细胞癌42例临床病理分析

目的探讨转移性透明细胞性肾细胞癌(clear cell renal cell carcinoma,CCRCC)的临床病理学特征、诊断及鉴别诊断。方法回顾性分析42例转移性CCRCC的临床病理资料,并复习相关文献。结果 42例转移性CCRCC中,男性35例,女性7例;转移部位依次为肺19例,骨8例,淋巴结及软组织各3例,肾上腺、皮肤及脑各2例,肝、小肠及鼻腔各1例。42例转移性CCRCC中,31例于肾原发灶手术切除后3周~11年出现转移,4例原发灶与转移灶同时发现;28例转移灶为单发,14例为多发性。34例转移性CCRCC仍具有原发性CCRCC的组织学形态,4例出现多灶状坏死,6例呈肉瘤样分化。Fuhrman细胞核分级:Ⅰ级4例、Ⅱ级13例、Ⅲ级18例、Ⅳ级7例。17例间质小血管呈簇状增生。免疫组化标记42例转移性CCRCC中CD10、vimentin、CAⅨ、PAX8、RCC和EMA阳性例数分别为39例(92.9%)、40例(95.2%)、38例(90.5%)、38例(90.5%)、31例(73.8%)和38例(90.5%)。结论转移性CCRCC具有独特的临床病理学特征,结合临床病史及肿瘤组织形态学特点,联合免疫组化标记vimentin、EMA、CD10、CAⅨ、PAX8等有助于诊断及鉴别诊断。     

肾盂移行细胞癌合并肾平滑肌肉瘤一例

患者女 ,5 6岁。左侧腰部阵发性钝痛 2个月 ,伴左上腹放射痛 ,无尿频、尿急、尿痛 ,无肉眼血尿 ,于 1998年 7月 2 0日入院。MRI示左肾肿瘤。尿常规示红细胞 (镜检 ) ++。手术见 :左肾增大 ,约 12cm× 7cm ,肾上极质地偏软 ,腹主动脉旁淋巴结增大 ,约 0 4cm× 0 8cm ,质软。病理检查 :大体标本 :左肾 11cm× 8cm× 6cm ,质稍软 ,包膜完整 ,表面光滑。切面见灰白色、乳头状肿物填充整个肾盂至肾小盏 ,界限清楚 ,质脆 ,浸润至外膜 ;肾实质见不规则结节状肿块 ,大小约 7 5cm× 4 0cm ,呈浸润性生长 ,界限不清 ,部分有假包膜 ,切面灰白色 ,…     

透明细胞性肾细胞癌中MYBL2表达及临床意义

目的 探讨骨髓母细胞增生症病毒癌基因同源物样2(MYB proto-oncogene like 2,MYBL2)在透明细胞性肾细胞癌(clear cell renal cell carcinoma,ccRCC)中的表达及其与临床病理特征的相关性.方法 应用qRT-PCR法检测ccRCC及癌旁正常肾组织中MYBL2 mR...     

肾血管平滑肌脂肪瘤伴发透明细胞癌

3例患者男性2例,女性1例,平均年龄57岁,均以腰痛不适于2004-2005年就诊,均未有合并结节性硬化症及其家族史,影像学诊断1例为脂肪瘤,另2例为肾癌,均行肾切除术,随访1-19个月均无复发转移。     

甲状腺转移性肾透明细胞癌一例

患者女,71岁.因发现左侧甲状腺肿块3个月于2009年12月入院.患者自述3个月前发现左侧甲状腺肿块,无疼痛、声嘶、吞咽困难、咳嗽、发热及心悸等,未行治疗.近1个月肿块有所增大而住院诊治.5年前因"肾透明细胞癌"行肾脏切除.体检:左颈部触及一个大小约3.5 cm×3.0 cm×3.0 cm的包块.与周围组织界限清楚,质软.CT检查示:左侧甲状腺占位性病变,大小3.2 cm×2.6 cm×2.2 cm.血甲胎蛋白(AFP)、癌胚抗原(CEA)正常,甲状腺功能检查正常.临床诊断:甲状腺腺瘤.     

Renal cell carcinoma with non-Hodgkin's lymphoma infiltration: a case report

The coexistence of renal cell carcinoma and non-Hodgkin's lymphoma is more common than expected in the general population; however, renal cell carcinoma with infiltration by non-Hodgkin's lymphoma has rarely been reported. Here we report on a 77-year-old patient who presented with small lymphocytic lymphoma in the jugulodigastric lymph node. He underwent nephrectomy for a renal mass 5 months later. On histopathological examination, the mass was diagnosed as a grade III renal cell carcinoma with infiltrated small lymphocytic lymphoma that was positive for B-cells (CD20). This case is discussed in terms of the coexistence of these tumors and tumor to tumor metastasis.     

Carcinosarcoma and squamous cell carcinoma of the renal pelvis associated with nephrolithiasis: a case report of each tumor type

Both squamous cell carcinoma and carcinosarcoma of the renal pelvis are uncommon. We report on two cases, one carcinosarcoma and one squamous cell carcinoma of the renal pelvis. In the patient with squamous cell carcinoma of the left kidney, the tumor was neither detectable on preoperative radiological evaluation nor grossly visible in the surgical specimen. This patient, a 56-year-old man, presented with left lumbar pain, hematuria, fever, 4-5 kg weight loss, and untreated nephrolithiasis of the left kidney that had been diagnosed 20 years earlier. The second patient, an 87-year-old woman, also had a long history of left kidney nephrolithiasis and presented with left lumbar pain and hematuria. Both patients underwent nephrectomy for removal of the non-functioning hydronephrotic left kidney. In both cases, microscopic examination of the surgical specimen revealed squamous metaplasia and dysplasia in the pelvicalyceal mucosa, and islands of atypical squamous cells in the renal parenchyma. In the second case, the kidney also showed sarcomatous changes in the pelvis.     

鼻腔原发性透明细胞癌一例

患者男,34岁.因反复间歇性右鼻出血1年余,流脓涕2个月于2009年8月入院.鼻腔CT显示右侧筛窦顶部嗅裂区见大小约1.8 cm ×0.8 cm条片状类似软组织密度影,边界清楚,邻近窦腔黏膜未见明显增厚,骨质完整(图1).胸腹CT及腹部B超未见异常.鼻腔检查见鼻腔黏膜光滑无充血,中下鼻甲无肿大,右鼻中道见脓涕,右侧嗅裂见新生物,色红,易出血,基底附着于筛顶部.鼻咽部未见异常.颈部淋巴结无肿大.行鼻内窥镜下右侧鼻腔新生物切除术并送病理检查.     

Urothelial signet-ring cell carcinoma of the renal pelvis with collagenous spherulosis: a case report

We present a unique case of urothelial carcinoma of the right renal pelvis. It occurred in a 58-year-old woman. The tumor was located in the renal pelvis with extension into the adjacent renal medulla and cortex. Two years after surgical excision the patient is free of recurrence and metastasis. The tumor was well demarcated, without capsule, firm, solid, and whitish on the cut surface. It was 3x4 cm in largest diameter and without signs of necroses and hemorrhages. The tumor did not infiltrate the ureter. Histologically the predominant pattern of the tumor was adenocarcinomatous differentiation, and only very rare foci of urothelial carcinoma composed of typical transitional cells were found. No signs of intestinal type of metaplasia and adenocarcinoma, changes similar to the cystitis cystica or cystitis glandularis, were found in the tumor or in its vicinity. Most of the tumor looked like solid nests composed of cells with intracytoplasmic lumens. The resulting appearance was that of typical signet-ring cell change. These solid nests were usually surrounded by columnar epithelium, which in many areas formed papillary structures. A very striking feature was formation of collagen spherules. Small collagen spherules were often surrounded by a layer of the neoplastic cells so that collagenous rosettes were formed. In some areas these collagenous spherules clustered together so that they formed areas of collagenous spherulosis. The collagen in the spherules reacted positively with collagen IV. Ultrastructurally these spherules were formed by basal membrane-like material. Intracytoplasmic lumens of the signet-ring cell change were endowed by slender microvilli at ultrastructural level.     

Invasive carcinoma arising from a colonic adenoma with clear cell change

Clear cell change (CCC) in colonic adenoma is rare, and its biological and clinical significance remains unknown. Malignant progression of an adenoma with CCC has seldom been reported. We report a case of a sigmoid adenoma with multiple foci of CCC associated with high-grade dysplasia and invasive carcinoma in a 62-year-old patient. We evaluated the histochemical and immunohistochemical characteristics of each component of the adenoma. In contrast to other parts of the adenoma, p53 was strongly and diffusely overexpressed in the areas of CCC, high-grade dysplasia, and carcinoma. The MIB-1 labeling index was also significantly higher in these components than in other parts of the adenoma. In conclusion, our findings suggest that CCC in adenoma may be associated with malignant progression of the adenoma. Hence, for practical purposes, we recommend considering CCC in colonic adenomas as a high-grade dysplasia equivalent and following up the patient accordingly.     

Metastatic endometrial endometrioid carcinoma with clear cell changes to the breast: a case report

Metastasis to breast from extramammary tissue is rare, and endometrial cancer has rarely been reported to metastasize to the breast. An extensive search in the medical literature reveals only 2 cases. They can be easily mistaken for primary breast carcinoma both clinically and radiologically, even with known history of endometrial carcinoma. This report presents a case of a 64-year-old woman who had endometrial carcinoma treated with total hysterectomy and adjuvant radiation and chemotherapy. Three years after the diagnosis, she had evidence of a solitary breast metastasis. To our knowledge, this is the third described case of endometrial cancer metastatic to the breast and the first in which the endometrial carcinoma demonstrates significant clear cell changes. This report is a reminder that although rare, endometrial carcinoma has the potential to metastasize to breast and illustrates how metastatic lesions in the breast can masquerade clinically as a primary carcinoma. Furthermore, essential guidelines necessary to distinguish primary from metastatic lesions in the breast are presented.