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目的:探讨肾脏嗜酸细胞瘤的症状、影像、病理、治疗及预后,以提高对该病的诊疗水平。方法:回顾分析2011年3月～10月我院收治2例肾脏嗜酸细胞瘤患者的临床资料,结合文献复习并讨论。结果:2例肿瘤大小分别为3.0cm×4.0cm和1.5cm×2.0cm。1例行左肾部分切除术,另1例行后腹腔镜下根治性左肾切除术,术后病理回报均为肾脏嗜酸细胞瘤。镜检:肿瘤细胞圆形或类圆形,细胞均匀一致,呈腺泡状或管状排列,胞质内富含嗜酸性颗粒,肿瘤中心部可见玻璃样变性无细胞区;免疫组化:EMA(+)、Vimentin(-)。本组中1例细胞核有一定程度异形性,另1例细胞核异形性明显,呈低度恶性。术后分别随访14个月及6个月,未见肿瘤复发,转移。结论:肾脏嗜酸细胞瘤是一种良性肿瘤,在临床症状、体征及影像学方面无明显特异性表现,确诊须依靠组织病理学检查。治疗以保留肾单位手术为宜,针对某些伴发恶性可能的肿瘤,肾根治性切除术也是积极的,术后需密切随访。
Objective: To investigate the symptoms, imaging, pathology, treatment and prognosis of renal oncocytoma in order to improve the diagnosis and treatment of the disease. Methods: The clinical data of 2 patients with renal oncocytoma admitted to our hospital from March to October in 2011 were analyzed retrospectively, and reviewed and discussed in the literature. Results: The size of the two tumors were 3.0cm × 4.0cm and 1.5cm × 2.0cm, respectively. One case underwent partial nephrectomy and the other one underwent laparoscopic radical nephrectomy. The postoperative pathological findings were renal oncocytoma. Microscopically, the tumor cells were round or round in shape with uniform cells with acinar or tubular arrangement. The cytoplasm was rich in eosinophilic granules and the glassy degenerated cell free zone was seen in the center of the tumor. Immunohistochemistry: EMA +), Vimentin (-). In this group, a case of nucleus has a degree of atypia, and the other case of obvious nuclear atypia, was low grade. The patients were followed up for 14 months and 6 months respectively. No tumor recurrence and metastasis were found. Conclusion: Kidney acid oncocytoma is a benign tumor, which has no obvious specificity in clinical symptoms, signs and imaging. The diagnosis depends on histopathology. Treatment to retain nephron surgery is appropriate, for some associated with malignant tumors, radical nephrectomy is also positive, follow-up after surgery.