乳头状肾细胞癌的临床特征及病理诊断

目的：探讨乳头状肾细胞癌的临床特征及其病理诊断要点。方法：收集4例乳头状肾细胞癌及43例非乳头状肾细胞癌，同时作常规H－E及免疫组化染色进行比较。结果：乳头状肾细胞癌是一种特殊类型的、恶性程度较低的肾细胞癌，临床经过长，生长缓慢，预后较好。大体检查肿瘤界线清楚；镜检肿瘤组织呈乳头状或管状乳头状排列，乳头中心及间质内有泡沫状细胞浸润。结论：乳头状肾细胞癌在临床表现、病理形态、生物学行为上均与其他类型的肾细胞癌不同，应将其作为一种独立的组织不类型诊断。

Clinical characteristics and pathological diagnosis of papillary renal cell carcinoma

Objectives:To study the clinical characteristics and the pathological diagnostic standards of papillary renal cell carcinoma(RCC). Methods:Histopathological and immunohistochemical changes of 4 cases of papillary RCC were compared with those of 43 cases of non papillary RCC. Results:Papillary RCC is a kind of special renal cell carcinoma. The course of the disease is longer and slower. The fact that papillary RCC has a better prognosis than conventional RCC has, which suggests that it is a tumor with lower malignant potential. It is radiographic hypovascular. On gross appearance, the tumor is completely or predominantly well circumscribed, with a thick fibrous capsule, hemorrhage and variable cystic degeneration. The histological architecture is papillary or tubupapillary. In the papillary core or space between papillae there is infiltration of foam cells. Other features of papillary RCC are hemorrhage and necrosis. Conclusions:Papillary RCC differs from non papillary RCC in clinical course, radiographic, pathological and biological behavior. Therefore, it should be classified as an independent histological type of RCC.