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目的探讨中肾管附件肿瘤的临床病理特征、免疫表型、鉴别诊断及预后。方法对5例中肾管附件肿瘤进行临床病理学观察和免疫表型研究,并复习相关文献。结果患者年龄39～61岁,平均年龄51.4岁。主要临床表现为腹痛、腹部膨隆和异常阴道流血。巨检:肿瘤最大径2～6cm,平均3.4cm;肿瘤界限清楚,切面灰白、灰红色,可见囊腔,囊腔内可见浆液或胶冻状液体。镜检:肿瘤组织内可见实性片状、小管状和筛状3种结构,管腔内可见红染物。肿瘤细胞为多角形,部分为梭形,细胞形态较温和,分裂象罕见。免疫表型:5例肿瘤CK7和vimentin均弥漫强(+),不同程度CD10、α-inhibin和calretinin(+);CK20、EMA、ER和PR(-)。结论中肾管附件肿瘤是一种罕见的具有低度恶性潜能的肿瘤,需进行长期的密切随访。
Objective To investigate the clinicopathological features, immunophenotypes, differential diagnosis and prognosis of the tumors in the accessory tube of the kidney. Methods The pathological and immunophenotypic studies of 5 cases of nephroureteral neoplasms were performed. The related literatures were reviewed. Results Patients aged 39 to 61 years, mean age 51.4 years. The main clinical manifestations of abdominal pain, abdominal distension and abnormal vaginal bleeding. The huge examination: the largest diameter of the tumor 2 ~ 6cm, an average of 3.4cm; clear tumor boundaries, gray-white section, gray red, visible cysts, cysts visible slurry or jelly-like liquid. Microscopic examination: visible solid tumor within the flake, tubular and sieve three kinds of structures, visible red staining within the lumen. Tumor cells for the polygons, some fusiform, cell morphology is more gentle, like splitting rare. Immunophenotype: CK7 and vimentin in 5 cases were diffusely strong (+), with varying degrees of CD10, α-inhibin and calretinin (+); CK20, EMA, ER and PR (-). Conclusions The nephrotic accessory tumor is a rare tumor with low malignant potential and needs long-term follow-up.