嗜酸性实性和囊性肾细胞癌(ESC RCC)——独特肾细胞癌亚型(ESC RCC)形态学和分子特征的进一步描述
  ——本文经《美国外科病理学杂志》授权发布,其他媒体转载或引用须经《美国外科病理学杂志》同意,否则追究法律责任。

  摘要:
  嗜酸性实性和囊性肾细胞癌(eosinophilic solid and cystic renal cell carcinoma,ESC RCC)是新近认识的一种独特类型的惰性肾肿瘤,发生在伴或者不伴有结节性硬化症的女性患者。尽管ESC RCC具有独特的组织学特点且常见CK20表达,但其分子核型特征仅在数例肿瘤中进行了研究。我们从多个医学中心的存档病例中找到了19例ESC RCC,所有患者均为女性且无结节性硬化症的临床表现。13例进行了分子核型分析(12例有结论性的分析结果)。中位年龄55岁(32~79岁)。肿瘤大体上呈实性和囊性外观、切面灰黄、中位大小31mm(12~135mm)。所有肿瘤均显示典型的显微镜下特征,即实性区域混有大小不等的巨囊性和微囊性囊肿。瘤细胞胞质嗜酸性,可见颗粒状的胞浆彩斑,核圆形至卵圆形。19例中有14例(73%)肿瘤表达CK20。19例中有17例(89%)患者病理分期为pT1期(12例为pT1a期,5例为pT1b期);各有1例患者为pT2a期和pT3a期。16例患者有随访信息,随访1到169 个月后(中位:44个月;平均:49.6个月),15例患者生存且无疾病进展证据;3例患者死于其它疾病。最常见的拷贝数获得为16p13.3-16q23.1(33%~67%)、7p21.2-7q36.2(42%~50%)、13q14.2(33%)以及19p12(33%)。最常见的拷贝数丢失包括Xp11.21(42%)以及22q11.23(33%)。杂合性丢失最常见于16p11.2-11.1(75%)、q11.1-13.1(75%)、Xq13.1-21.1(33%)、11p11.2-11.11(33%)、9q21.1-22.2(33%)以及9q33.1(33%)。ESC RCC显示重现性的分子核型异常,进一步支持其独特的属性。
  关键词:嗜酸性肿瘤,肾细胞癌,结节性硬化症,CK20,不能分类的嗜酸细胞肿瘤,不能分类的肾细胞癌。
来源:Am J Surg Pathol 2017;41:1299–1308
美国外科病理学杂志中文版2018年第一期全文No.3
(赵明 翻译 滕晓东 审校)









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