肾原发性平滑肌肉瘤3例病理分析

目的探讨原发于肾脏的平滑肌肉瘤的临床病理学特点、诊断、鉴别诊断、治疗及组织发生。方珐对3例肾平滑肌肉瘤进行常规HE、组织化学及免疫组织化学染色观察。焙杲3例显微镜下表现、组织化学及免疫组织化学染色均显示平滑肌源性肿瘤的特点。由病理确诊，术前无1例怀疑平滑肌肉瘤。2例分别于术后2个月、38个月后死亡，1例术后至今无复发（42月）。结论肾原发性平滑肌肉瘤罕见，临床诊断较困难，但依靠肾切除标本的病理检查，结合组织化学染色和免疫组织化学染色可确诊。该肿瘤恶性度高，预后较差。

Primary leiomyosarcoma of the kidney: 3 cases of pathobiological analysis

Objective To report three cases of leiomyosarcoma of the kidney. The morphological characteristics, diagnosis, therapeutic aspects, histogenesis as well as the prognostic factors of this tumor were reviewed. Methods Three specimens were stained with hematoxylin and eosin （HE） histochemical and immunohistochemical methods. Results The features of HE, histochemical and immunohistochemical staining showed that the tumor was originated from smooth muscle. In all 3 cases, 2 died of disease, 1 was alive with no evidence of disease. Conclusion Leiomyosarcoma of the kidney is an uncommon, highly malignant mesenchymal tumor with poor prognosis, which is difficult to diagnose. The tumor has its own pathological features, so a definite diagnosis can be made with the pathological examination of the kidney. The choice of treatment is radical nephrectomy.