后肾腺瘤5例临床及病理学特征分析

目的探讨后肾腺瘤(MA)的临床及病理学特征。方法总结5例MA的临床、影像学、病理学形态特征和免疫组化结果,并行文献复习。结果本组5例后肾腺瘤,男性1例,女性4例。CT平扫表现为界清低密度影;CT血管造影(CTA)提示瘤体呈少血管改变。肉眼观肿瘤境界清楚,呈灰白、灰黄色,质地中等;镜下肿瘤细胞小,均匀一致,核大质少,无异型性及核分裂象,肿瘤细胞呈腺泡状排列,可见乳头状结构,并可见砂砾体钙化。免疫组化示WT-1、CD57和vimentin均(+),S-100、CK7和CKpan部分(+),而CgA、Syn和EMA(-)。术后随访提示预后较好,无复发和转移征象。结论以病理学形态特征结合免疫组化有助于明确后肾腺瘤的诊断。

Clinical and pathological characteristics of metanephric adenoma: a report of 5 cases

Objective To explore the clinical and histopathological features of metanephric adenoma(MA).Methods Five MA cases were retrospectively recruited to analyze their clinical,imaging and histopathological data,and relevant literatures were reviewed.Results The tumor showed low density with a distinct boundary by plain CT scanning and less blood supply by CT angiography(CTA).Generally,it had a clear edge with grey or yellow or tan cut surface and moderate texture.Microscopically,the tumors were composed of benign small and cuboidual epithelial cells with scant cytoplasm and no heteromorphism and mitosis.They presented as aciniform arrangement.Additionally,papillary structures and psammoma bodies were also found.Immunohistochemical study showed that MA was positive for WT-1,CD57,and vimentin,partially positive for S-100,CK7 and CKpan,and negative for CgA,Syn and EMA.Long term follow-up showed the MA cases had a favourate prognosis after tumor excision.Conclusion MA is a rare renal benign tumor.It is helpful for diagnosis to master its clinical and histopathological characteristics.