多囊性肾细胞癌1例报道及文献复习

目的：阐明多囊性肾细胞癌的病理形态学特征及鉴别诊断要点。方法：报道1例多囊性肾细胞癌,结合文献对本病的临床病理特征进行探讨。结果：肿瘤由厚的假纤维被膜环绕,瘤体全部由大小不等的囊腔及无膨胀性实性结节的薄的间隔构成,囊腔被覆透明细胞,异形性小,间隔内含聚集的透明细胞上皮巢,结论：多囊性肾细胞癌是一种罕见的有低度恶性倾向的肿瘤,术前影像学,细胞学检查及术后的肉眼特征均与囊性肾瘤,囊性部分分化性肾母细胞瘤相似,最重要的是本瘤缺乏肉眼所见的膨胀性实性结节,显微镜下的关键特征是间隔内可见聚集的透明细胞巢。     

囊性肾细胞癌3例报道及文献复习

目的探讨囊性肾细胞癌的病理形态学特征及鉴别诊断。方法对3例囊性肾细胞癌进行光镜观察及免疫组化标记,并复习文献。结果肿瘤有确切的瘤体,由厚的假纤维包膜围绕,切面见大小不等的囊腔。镜下见囊腔被覆无明显异型的透明细胞,纤维性囊壁间隔中可见透明细胞巢。免疫表型:透明细胞CK、EMA强阳性,CD68、M ac387阴性,K i-67、p53弱阳性。结论囊性肾细胞癌少见,预后好,术前易与多囊肾、囊性变肾细胞癌和囊性肾瘤等混淆。本瘤的特征是囊性区显著,囊腔内衬单层或数层异型小的透明细胞,囊壁之间可见透明细胞巢。     

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。     

伴有显著血管平滑肌瘤样增生的肾细胞癌

肾透明细胞癌通常具有丰富的窦状血管网，这一特点有助于与其它脏器发生的透明细胞肿瘤鉴别，同时有研究提示肿瘤的血管形成与瘤细胞分泌的血管生长因子有关。作者报道了5例伴有显著血管平滑肌瘤样增生的肾透明细胞癌，并认为这种增生可能是伴随肾透明细胞癌出现的非肿瘤性血管增生的另一种表现形式。此组患者年龄37～75岁（平均53岁），4例为女性。均无结节性硬化。5例肿瘤均为孤立性，直径1．8-4cm。肿瘤界限清楚，具有厚而不规则的包膜。2例肿瘤中央可见纤维瘢痕，并有白色条索与包膜相连。肿瘤切面呈多彩状，可见红褐色、黄色和半透明白色区域及囊性变、坏死灶和局灶钙化。组织学观察：肿瘤最具特点的表现是两种不同成分混合存在：上皮性透明细胞肿瘤成分和具有血管平滑肌瘤样外观的间质成分。[第一段]     

囊性肾细胞癌临床病理分析

囊性肾细胞癌是一种罕见的肾癌。我们报道3例囊性肾细胞癌,并结合临床病理特征复习有关文献。1材料与方法1.1材料收集鄞州人民医院1998年1月～2003年5月确诊的3例囊性肾细胞癌,其中1例快速冷冻时曾误诊为脉管性错构瘤。3例均为男性,年龄45～62岁,例1有上腹隐痛伴右腰部酸胀不适     

基于多字典学习框架的肾透明细胞癌预后分析模型

肾透明细胞癌是一种高度异质的肿瘤,具有复杂多变的临床表现.基于病理全切片图像的肾透明细胞癌自动预后分析,可辅助医生做出临床决策,从而达到更好的治疗目的.肾透明细胞癌的组织异构性使得针对预后分析任务的特征提取存在很大的挑战性.提出针对肾透明细胞癌病理全切片图像的多字典学习框架,自适应获取病理全切片图像的有效信息,进行肾透...     

多囊性肾细胞癌

多囊性肾细胞癌（MCRCC）,也叫多囊性透明细胞肾细胞癌（RCC）和多囊性透明细胞癌,是一种预后较佳的少见的肾脏囊性肿瘤。2004年WHO肾肿瘤分类中将MCRCC作为透明细胞肾细胞癌的一种罕见亚型,其预后较佳。虽然文献报道囊性肾细胞癌比实体型透明细胞RCC预后好,但对于诊断MCRCC真正的临床意义和其预后还不清楚。作者根据WHO2004年的诊断标准收集了45例MCRCC,年龄30～80岁,平均54．3岁。男性28例,年龄36～80岁,平均56．3岁;女性17例,年龄30～78岁,平均51．1岁。50％的患者年龄小于50岁。肿瘤直径1—14cm,平均4．9cm,     

多房囊性肾细胞癌18例临床病理分析

目的：探讨多房囊性肾细胞癌（ mu1ti1ocu1ar cystic rena1 ce11 carcinoma,MCRCC）的临床病理学特征、诊断及鉴别诊断。方法回顾性分析18例MCRCC的临床病理学及免疫表型特征,并复习相关文献。结果18例中男性12例,女性6例,年龄26~68岁（平均55.6岁）。影像学检查均示多囊性占位,边界清楚。眼观：肿瘤切面见大小不等的多房囊腔,内含浆液性或血性液体。镜检：肿瘤囊内壁被覆单层透明细胞、复层上皮或上皮缺如,囊内成分大部分流失,纤维性囊壁或囊腔间隔中见灶状透明细胞,呈Ⅰ级细胞核,其为形态学诊断线索。免疫表型：透明细胞CD10、vimentin、EMA均阳性,Ki-67增殖指数低。18例患者平均随访43个月,均无复发或转移,预后良好。结论 MCRCC是一种罕见的肾细胞癌组织学亚型,预后良好,需与肾透明细胞癌囊性变及良性肾囊性病变相鉴别。     

肾透明细胞癌N-WASP蛋白表达特点及与临床病理相关性

目的研究肾透明细胞癌组织及癌旁正常肾组织中N-WASP表达特点及与临床病理的相关性。方法对73例肾透明细胞癌组织及癌旁正常肾组织行N-WASP免疫组织化学染色,比较两组表达差异。对癌组织N-WASP表达水平与肿瘤病理分级,临床分期进行相关性分析。对总体生存率行单因素及多因素预后分析。结果癌组织N-WASP表达低于癌旁组织表达(P0.001)。癌组织中N-WASP低、中表达的患者生存率高于高表达患者(P0.01)。癌组织N-WASP表达水平(P0.01)与患者总体生存率相关。癌组织N-WASP表达水平可以作为判断肾透明细胞癌预后的独立预测因素(P0.05)。结论 N-WASP在肾透明细胞癌中表达明显下降,并可以作为独立预测因素提示患者预后。     

具有透明细胞乳头状肾细胞癌形态特征的透明细胞性肾细胞癌的临床病理特征

目的探讨具有透明细胞乳头状肾细胞癌形态特征的透明细胞性肾细胞癌(clear cell papillary renal cell carcinoma-like clear cell renal carcinoma, CCPRCC-like CCRCC)的临床和病理特征, 旨在提高对该类肿瘤的认识。方法回顾性分析浙江大学医学院附属第一医院诊断的3例CCPRCC-like CCRCC的临床资料、组织学形态及免疫表型, 随访患者预后并复习相关文献。结果男性2例, 女性1例, 平均年龄43岁。肿块最大径9 cm。镜下观察3例病例均包含透明细胞乳头状肾细胞癌样(CCPRCC-like)及透明细胞性肾细胞癌样(CCRCC-like)两种区域, 前者在整个瘤体所占比例为20%～90%。CCPRCC-like区域含有囊、乳头、腺管状结构。细胞核远离基底膜, 细胞核WHO/国际泌尿病理协会(ISUP)分级1级。在CCPRCC-like区域, 细胞角蛋白(CK)7表达范围10%～80%, 中等及以上强度表达。CD10表达均为100%, 主要为顶端胞膜表达。在CCRCC-like区域, 1例CK7阴性, 其余...     

Synchronous squamous cell carcinoma of the kidney,squamous cell carcinoma of the ureter,and sarcomatoid carcinoma of the urinary bladder: A case report

The author presents a unique case of a synchronous triple carcinoma of kidney, ureter, and urinary bladder. A 73-year-old man was admitted to our hospital because of hematuria and lumbago. Endoscopy and imaging modalities revealed a bladder tumor, a left ureter tumor, and a left kidney tumor. No other tumors were found in the body by imaging modalities. Cystectomy and left nephroureterectomy were performed. The bladder tumor was a large polypoid tumor consisting of pleomorphic sarcomatoid carcinoma (80%) and high-grade papillary urothelial carcinoma (20%), both invading the deep muscle layer. There were gradual merges between the two. The sarcomatous component was composed of malignant spindle, polygonal, and giant cells. Lymphovascular permeation was pronounced. Immunohistochemically, the sarcomatous element was positive for vimentin and various types of cytokeratins (CK), while the urothelial carcinoma element was positive for various types of CK and negative for vimentin. The ureter tumor was small and obstructed the ureter lumen. It was a pure squamous cell carcinoma without a urothelial component. The ureter tumor invaded the adventitia. A mild degree of lymphovascular invasion was recognized. Immunohistochemically, the tumor cells were positive for various types of CK but negative for vimentin. In the kidney, almost the entire kidney parenchyma was replaced by a tumor. The renal pelvis was broadly erosive but was free of apparent tumors. Histologically, the renal tumor was a pure squamous cell carcinoma without a urothelial component. Broad necrosis was present, and lymphovascular permeation was pronounced. The renal pelvis and calices were devoid of apparent tumor cells, but renal squamous cell carcinoma was present just beneath the pelvis and calices. Immunohistochemically, the kidney tumor was positive for various types of CK and negative for vimentin.     

Inhibition of γ-secretase by retinoic acid chalcone (RAC) induces G2/M arrest and triggers apoptosis in renal cell carcinoma

The present study was devised to investigate the effect of RAC on inhibition of cell proliferation and apoptosis of renal carcinoma cells. MTT assay and flow cytometry analysis were used to determine cell proliferation and apoptosis along with cell cycle examination. Western blot analysis and immunohistochemistry were used for the detection of expression levels of Notch1 and Jagged1 in renal cell carcinoma (RCC) and normal kidney tissues. The results revealed a significant inhibition of cell proliferation, G2/M phase cell cycle arrest and cell apoptosis at 30 μM concentration of RAC after 72 h. In ACHN and 769-P cells, the population in G2/M phase was increased to 45.27, and 54.23% respectively on treatment with 30 μM RAC for 72 h. In 769-P and ACHN renal carcinoma cells treatment with 30 μM RAC caused 69.71 and 59.27% of the cells to undergo apoptosis compared to 5.23 and 4.93% respectively in control cells. The positive staining rates of Notch1 and Jagged1 in renal carcinoma tissues were 95.3 and 93.0% compared to normal kidney tissues 36.4 and 42.4% respectively. Treatment of renal carcinoma tissues caused a significant decrease in staining rates of Notch1 and Jagged1 after 96 h. Thus RAC can be a potent agent in the treatment of renal cell carcinoma.     

A novel case of concurrent renal tumors: chromophobe renal cell carcinoma and carcinoid tumor of the kidney with brief review of renal neuroendocrine tumors

Renal cell carcinoma of chromophobe type is a malignant neoplasm with characteristic large cells that exhibit prominent cell membranes. Primary renal carcinoid tumors are rare tumors with the histological appearance similar to well-differentiated neuroendocrine tumors at other sites. Chromophobe renal cell carcinoma with neuroendocrine differentiation is exceedingly rare. The authors describe a case of a chromophobe renal cell carcinoma and carcinoid tumor of the kidney presenting as distinct masses in the same kidney in a 34-year-old male. The histologic and immunohistochemical features of both the tumors were characteristic with no overlapping features. The carcinoid tumor presented at a higher stage with nodal metastasis. To the best of the authors' knowledge, this is the first case of 2 morphologically distinct tumors, one chromophobe renal cell carcinoma and the other primary carcinoid tumor in the same kidney.     

Myxoid Leiomyosarcoma of the Kidney Accompanying Ipsilateral Ureteral Transitional Cell Carcinoma: A Case Report with Cytological, Immunohistochemical and Ultrastructural Study

The authors report a case of myxoid leiomyosarcoma of the kidney accompanying ipsilateral ureteral transitional cell carcinoma. A 74-year-old male patient complained of turbid urine and macroscopic hematuria. He also complained of left back pain, appetite loss and weight loss. Computed tomography revealed a large mass in the left retroperitoneum. Urine cytology disclosed two types of malignant cells, atypical spindle-shaped cells and transitional cell carcinoma. Left total nephro-ureterectomy was performed. The left kidney was occupied by a 6X4X4 cm, multinodular and mucinous tumor. A transitional cell carcinoma of the left ureter was also observed. The renal tumor was composed of atypical spindle-shaped cells in the mucinous stroma, which showed positive immunoreactivity for anti-muscle-specific actin and anti-desmin antibodies. The ultrastructural examination revealed intracytoplasmic microfilaments with dense bodies, pinocytotic vesicles and junctional structure. These findings were suggestive of the myogenic feature of the case. Urine cytology revealed a number of sarcoma cells in this case since the sarcoma cells markedly invaded the renal pelvis and were apt to separate individually in myxoid stroma. Simultaneous and ipsilateral double malignancies of the renal sarcoma and ureteral transitional cell carcinoma have never been reported in the literature. Acta Pathol Jpn 41: 694–700, 1991.     

Myxoid leiomyosarcoma of the kidney accompanying ipsilateral ureteral transitional cell carcinoma. A case report with cytological, immunohistochemical and ultrastructural study.

The authors report a case of myxoid leiomyosarcoma of the kidney accompanying ipsilateral ureteral transitional cell carcinoma. A 74-year-old male patient complained of turbid urine and macroscopic hematuria. He also complained of left back pain, appetite loss and weight loss. Computed tomography revealed a large mass in the left retroperitoneum. Urine cytology disclosed two types of malignant cells, atypical spindle-shaped cells and transitional cell carcinoma. Left total nephro-ureterectomy was performed. The left kidney was occupied by a 6 x 4 x 4 cm, multinodular and mucinous tumor. A transitional cell carcinoma of the left ureter was also observed. The renal tumor was composed of atypical spindle-shaped cells in the mucinous stroma, which showed positive immunoreactivity for anti-muscle-specific actin and anti-desmin antibodies. The ultrastructural examination revealed intracytoplasmic microfilaments with dense bodies, pinocytotic vesicles and junctional structure. These findings were suggestive of the myogenic feature of the case. Urine cytology revealed a number of sarcoma cells in this case since the sarcoma cells markedly invaded the renal pelvis and were apt to separate individually in myxoid stroma. Simultaneous and ipsilateral double malignancies of the renal sarcoma and ureteral transitional cell carcinoma have never been reported in the literature.     

Chromophobe renal cell carcinoma,eosinophilic variant with papillary growth: a case report

We report the case of an 80-year-old man who presented with pathologically diagnosed chromophobe renal cell carcinoma composed of eosinophilic cells with partial papillary growth. The patient had a 2.5 cm diameter renal mass incidentally detected by abdominal ultrasound examination. Laparoscopic left partial nephrectomy was performed under a diagnosis of left renal tumor. Histopathology demonstrated uniform eosinophilic cuboidal cells growing with a partially papillary pattern: differential diagnosis of oncocytoma, papillary renal cell carcinoma, or oncocytic papillary renal cell carcinoma was necessary. Immunohistochemical staining with anti-monoclonal antibody 31 and -CD82 antibody, and choroid iron staining, were positive. Cytogenetic analysis by comparative genomic hybridization showed gains of chromosomes 1p, 9q, 19q, 20, and 21q, and losses of chromosomes 1p and q, 2q, 6q and 7q, leading to diagnosis of chromophobe RCC. We describe differential diagnosis for chromophobe renal cell carcinoma, eosinophilic variant, growing in a papillary fashion in the kidney.     

Tubulocystic carcinoma of kidney associated with papillary renal cell carcinoma

Tubulocystic renal cell carcinoma (TCRCC) is a rare variant of renal cell carcinoma, which has distinct histology but there is some controversy about its association with papillary renal cell carcinoma (PRCC) and cell of origin in literature. We report an 18-year-old girl with the rare TCRCC of kidney associated with PRCC with metastases to the para-aortic nodes. The patient presented with hematuria and a right renal mass with enlarged regional nodes for which a radical nephrectomy with retroperitoneal lymph node dissection was done. On gross examination, a solid cystic lesion involving the lower pole and middle pole of the kidney measuring 12x9x9 cm was seen along with an additional cystic lesion in upper pole of kidney. Microscopically the main tumor showed the typical histology of a tubulocystic carcinoma with multiple cysts filled with secretions lined by variably flattened epithelium with hobnailing of cells. The mass in the upper pole was a high-grade PRCC and the nodal metastases had morphology similar to this component. To conclude, at least a small but definite subset of TCRCC is associated with PRCC, and cases associated with PRCC do seem to have a higher propensity for nodal metastasis as in the case we report.     

Rare renal tumor--mucinous tubular and spindle cell carcinoma

We report a rare case of renal tumor--mucinous tubular and spindle cell carcinoma in a 65-year-old man. The tumor, located in the right kidney, was well circumscribed. Microscopically, the tumoral proliferation was composed of cuboidal cells arranged in tubules, with abrupt transition to spindle cell morphology in a myxoid stroma. Because of the favorable prognosis with this type of tumor, mucinous tubular and spindle cell carcinoma must be differentiated from papillary renal cell carcinoma, especially the variant with sarcomatoid dedifferentiation.