肾源性腺瘤临床病理分析

目的 探讨肾源性腺瘤(Nephrogenic adenoma,NA)临床病理特征及免疫组化。 方法? 收集13例来源于肾、膀胱、输尿管的NA,分析其临床病理特点。 结果? 男性11例,女性2例。受累部位:输尿管7例、膀胱5例、膀胱及输尿管1例、肾盂2例。NA大体呈输尿管狭窄(6/7),膀胱壁粗糙(3/5)及肾盂息肉(2/2)表现。镜下特征为管状(13/13)及管状乳头状(7/13)结构,被覆立方/柱状上皮(13/13),或混合鞋钉样嗜酸上皮(12/13)。间质疏松,内含不等量血管及炎细胞(13/13)。免疫组化示CK7、PAX-8、CK19、CK8特异表达。 结论 NA为泌尿系统罕见肿瘤,组织学特征独特,有过诊疗和漏诊风险,也有复发和恶变潜能。确诊需病理诊断,免疫组化检测有助于病理诊断。

Analysis of the clinicopathological characteristics of Nephrogenic adenoma

Purpose To learn the clinicopathological and immune-histochemical features of Nephrogenic adenoma (NA). Methods The clinical and pathological data of 13 cases of NA, involving the kidney, bladder or ureter, were collected and analyzed. Results There were 11 males and 2 females. Organ involved: ureter 7 cases, bladder 5 cases, bladder and ureter 1 case, renal pelvis 2 cases. NA was typically manifested as ureteral stenosis (6/7), rough bladder wall (3/5), and renal pelvis polyp (2/2). The typical microscopical features are tubular (13/13) and tubular and papillary (7/13) structures, covered with cuboidal or columnar epithelium (13/13), or a mixed hobnail-spike eosinophilic epithelium (12/13). The interstitium was loose, containing varied amounts of vasculature and inflammatory cells (13/13). Immunohistochemistry revealed specific expressions of CK7, PAX-8, PAX2, CK19 and CK8. Conclusion NA is a rare neoplasm of the urinary tract with unique histological features, risk of misdiagnosis and over-treatment, and the potential for recurrence and malignant conversion. The diagnosis of NA depends on pathology, and the immunohistochemistry can be an adjunct.