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目的:探讨肾黏液样小管状和梭形细胞癌(mucinous tubular and spindle cell carcinoma,MTSCC)的临床病理学特征、鉴别诊断、起源、治疗及预后。方法:观察1例MTSCC的临床病理学特征及应用Elivision法进行免疫组织化学检测,同时术后随访相关情况。结果:镜下瘤组织主要由上皮样细胞呈狭长小管状、索状排列和弥漫的梭形细胞几种结构紧密排列在黏液样基质中构成,部分迷路乳头状结构,梭形细胞区较少,似平滑肌瘤。瘤细胞形态温和,异型性小,核圆形或卵圆形,核仁不明显,核分裂象罕见。免疫组织化学检查瘤细胞CK、vimentin+,CD10、CD15-,CK34βE12、CK7、CK19在迷路样区域+,在索状、小管状区域-,迷路样区域Ki-67指数最高,达4%。患者行肿瘤及部分肾切除术,术后未行特殊治疗,随访5个月,无复发和转移。结论:MTSCC是肾原发性罕见低度恶性肿瘤,来源不定,可能起源于多种组织。肿瘤局部切除的预后不确定。
OBJECTIVE: To investigate the clinicopathological features, differential diagnosis, origin, treatment and prognosis of renal mucinous tubular and spindle cell carcinoma (MTSCC). Methods: The clinical and pathological features of one case of MTSCC were observed and the immunohistochemistry was performed using the Elivision method. At the same time, the related situation was followed up. Results: The microscopic tumor mainly consisted of epithelial-like cells in narrow and small tubules, cord-like arrangement and diffuse spindle-shaped cells arranged closely in the mucous-like matrix, partially lost papillary structure, with fewer spindle-shaped cells, Like leiomyoma. Mild tumor cells, atypia small, round or oval nucleus, nucleoli are not obvious, as rare as mitotic. Immunohistochemistry showed that Ki-67 index was the highest in cord-like, tubule-shaped, and labyrinthine lesions with CK, vimentin +, CD10, CD15-, CK34betaE12, CK7 and CK19 in the labyrinthine region. Patients with tumor and partial nephrectomy, no special treatment after surgery, follow-up of 5 months, no recurrence and metastasis. Conclusions: MTSCC is a rare primary malignant neoplasm of kidney originating from a variety of tissues. The prognosis of tumor resection is uncertain.