Clinical,radiological and pathological diagnosis of renal solitary fibrous tumor (Report of 2 cases and review of literature)
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摘要: 目的：探讨肾孤立性纤维瘤的临床、影像学及病理特征，并进行诊断和鉴别诊断，提高对该肿瘤的诊断水平。方法：对2例肾孤立性纤维瘤进行临床症状，影像学资料以及病理分析，并结合文献讨论。结果：2例肿瘤均位于左肾，1例来源于肾实质，1例与左肾盂关系密切，临床、影像学诊断为左肾癌，均行左肾根治性切除术，肿瘤大体为球形或表面略分叶状的包块，边界清楚，包膜完整。镜下梭形细胞呈束状、旋涡状或不规则状排列，部分与胶原纤维混杂，部分呈血管外皮瘤样结构。细胞无明显异型，核分裂象未见。免疫组化示肿瘤细胞CD34 及CD99 阳性，S100，SMA，CKpan，P63，HMB45均为阴性，确诊为肾脏孤立性纤维瘤，2例均随访6个月无复发转移。结论：肾孤立性纤维瘤是一种少见的肾脏肿瘤，临床及影像学上易误诊为肾癌或肾盂癌，免疫组化CD34阳性表达是其病理学特征性表现，根治性切除及术后长期随访是治疗肿瘤的必要手段。Abstract: Objective: To study the clinical, radiological, pathological features and differential diagnosis of solitary fibrous tumor (SFT) of kidney, to improve the diagnosis level of the tumor.Method: Two cases of renal SFT were analyzed from the clinical symptoms, radiological data and pathological features, and with related literature reviewed.Result: Two tumors all occurred in left kidney, one origin from the renal parenchyma, the other one origin closely related to pelvis,which was clinically and radiologically thought to be renal cell carcinoma and underwent left radical nephrontectomy. Grossly, the tumor was a well-circumscribed, with lobular or spherical mass, without necrosis or hemorrhage. Microscopically the bland spindle cells proliferated with the vortex-shaped or irregular-shaped arrangement, part of the collagen fibers mixed, in part showed hemangiopericytoma-like structure and were accompanied by hyalinized collagenous tissue. Immunohistochemical analysis showed that the tumor cells were diffusely positive for CD34 and CD99, negative stain for S100, SMA, CKpan, P63 and HMB45. From the characterized CD34, CD99 positive stain, two case were diagnosed as SFT and no tumor recurrence and metastasis with 6 months follow-up.Conclusion: Renal SFT is a very rare disease and often misdiagnosed as renal cell or pelvis carcinoma, immunohistochemical CD34 positive stain is characterized in this tumor, radical resection and long term follow-up is necessary for the treatment of this kind of tumor.
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Key words:
- kidney /
- solitary fibrous tumor /
- CD34 /
- CD99
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