具有绒毛膜癌样特征的肾盂尿路上皮癌1例临床病理分析

目的:阐明具有绒毛膜癌样特征的肾盂尿路上皮癌临床病理特点。方法:回顾性分析1例具有绒毛膜癌样特征的肾盂尿路上皮癌患者的临床、影像、组织学和免疫组织化学特点。结果:患者CT检查发现右侧肾盂结节状类软组织密度影，遂行根治性肾脏切除术。术后病理检查显示肿瘤组织广泛坏死、出血，由类似于绒毛膜癌的细胞滋养层细胞和合体滋养层细胞组成，并与正常尿路上皮存在移行。免疫组织化学染色两类肿瘤细胞均阳性表达AE1/AE3、CK7及β-HCG，合体滋养层细胞阳性表达α-inhibin。经术后随访15个月，至今无瘤生存。结论:具有绒毛膜癌样特征的肾盂尿路上皮癌极为罕见，诊断时需要与转移性绒毛膜癌鉴别。

Urothelial carcinoma of the renal pelvis with choriocarcinomatous features:A clinicopathologic analysis of 1 case

Objective：To investigate the clinicopathological characteristics of urothelial carcinoma with ehoriocar- cinomatous features in renal pelvis. Methods：Clinical manifestations, radiological and pathological features of urothe- lial carcinoma with choriocarcinomatous features in renal pelvis were analyzed retrospectively. Results： A 68 - year - old female patient presented with painless macrohematuria and lumbodynia. The computerized tomography （CT） showed a nodular soft tissue mass occupying the right renal pelvis. Therefore a nephrectomy was performed. On patho- logic examination,the tumor was consisted of giant syncytiotrophoblasts and cytotrophoblasts with extensive necrosis and hemorrhage. Immunohistochemieal staining showed these two type cells were positive expression for AE1/AE3, CK7 and 13 - HCG. The positive staining of a - inhibin was exhibited merely in syncytiotrophoblasts. The patient has been followed for 15 months without recurrence until now. Conclusion：Urothelial carcinoma with choriocarcinomatous features is a rare malignancy arising in the renal pelvis. The most important differential diagnostic consideration is the metastatic choriocarcinoma.