摘要
目的研究甲状腺样滤泡性肾细胞癌的临床病理特征。方法回顾4例TLFRCC临床资料,行HE、免疫组化及BRAF V600E/RAS基因检测并复习相关文献。结果其中男性3例,女性1例,平均年龄48岁,肿瘤平均直径4.8cm。大体均为单发结节,切面呈灰黄暗红色,界清,质软,可伴出血及坏死,2例呈微囊性。镜下肿瘤由大小不等的滤泡组成,间质富于毛细血管,周围包裹纤维性包膜。腔内富含嗜酸性物质,核呈磨玻璃样。免疫组化示上皮表达CK、EMA、GATA3、P504S、34βE12、PAX8,TTF-1和TG阴性具有诊断价值,1例表达神经内分泌标记;Ki-67约5%。PCR检测无BRAF V600E和RAS突变。术后随访24~96个月均无复发。结论TLFRCC是一种极为罕见的肾癌亚型,具有类似甲状腺滤泡癌的形态特征,生物学行为低度恶性,充分认识避免误诊,为临床治疗提供指导。
Objective To study the clinicopathological features of thyroid-like follicular renal cell carcinoma.Methods Clinical data of 4 cases of TLFRCC were reviewed.HE,immunohistochemistry and BRAF V600E/RAS gene were detected and related literature was reviewed.Results There were 3 males and 1 female with an average age of 48 years.The average diameter of the tumor was 4.8cm.Single nodules,section of the gray yellow dark red,clear,soft,can be accompanied by hemorrhage and necrosis.Microcystic in 2 cases.the tumor is composed of follicles of varying sizes.The interstitium is rich in capillaries and surrounded by a fibrous capsule.The lumen is rich in eosinophilic substances and the nucleus is ground glass like.Immunohistochemistry showed negative expression of CK,EMA,GATA3,P504S,34βE12,PAX8,TTF-1 and TG in the epithelium,which had diagnostic value.Neuroendocrine markers were expressed in 1 case.Ki-67,about 5%.No BRAF V600E and RAS mutations were detected by PCR.There was no recurrence during the follow-up period of 24 to 96 months.Conclusion TLFRCC is an extremely rare subtype of renal carcinoma,with morphological characteristics similar to thyroid follicular carcinoma,and low-grade malignant biological behavior.Full understanding to avoid misdiagnosis can provide guidance for clinical treatment.
作者
许静
樊漪波
颜彬
刘利明
XU Jing;FAN Yi-bo;YAN Bin;LIU Li-ming(Department of Pathology,the Second Medical College of Ji′nan University(Shenzhen People’s Hospital),Shenzhen 518020,Guangdong Province,China)
出处
《罕少疾病杂志》
2021年第4期4-6,共3页
Journal of Rare and Uncommon Diseases
基金
深圳市科技创新委员会基础研究面上项目(JCYJ20190806154610953)。
关键词
肾细胞癌
甲状腺样
滤泡癌
免疫组织化学
Renal Cell Carcinoma
Thyroid-Like
Follicular Carcinoma
Immunohistochemistry
作者简介
第一作者/通讯作者:许静,女,主治医师,主要研究方向:肿瘤病理。E-mail:xujingviky@163.com。
