后肾腺瘤临床病理误诊及文献复习

后肾腺瘤临床病理误诊及文献复习
周萍;朱正龙;张伟;戴黄琼;吴艳
【期刊名称】《临床误诊误治》
【年(卷),期】2016(29)12
【摘要】Objective To investigate clinicopathological features and key points for diagnosis and differential diagno-sis of metanephric adenoma ( MA) . Methods Clinical data of 1 MA patient was retrospectively analyzed, and the related lit-erature was reviewed. Results The patient was admitted for right upper abdominal pain associated by nausea and vomiting for 3 d. Right renal space-occupying lesion was primarily diagnosed by Bultrasound, CT and MRI examinations, and then surgical treatment was performed. A 8 cm × 5 cm × 3 cm round-like tumor and gray red and gray white in cutting surface with peplos and clear demarcation from the surrounding tissue was cut. Pathological test for intraoperative quickly frozen sections showed that the tumor was composed of smaller cells with the same size, less cytoplasm without nuclear atypia or pathological mitosis. The tumor cells were fine papillary, small tubular arrangement, interstitial little staining, edema in some areas without
embryo&nbsp;tissue or calcification. Postoperative immunohistochemical staining showed that MA was positive for Vimentin, WT1, CD57, CKpan, S-100 and Ki67 ( <2%) . Metanephric adenoma was confirmed. The patient was discharged after postoperative re-covery well, and no recurrence was
found during 4 years of follow-up. Conclusion MA is a rarely primary renal tumor origi-nating from epithelium, and it is easily misdiagnosed as nephroblastoma by intraoperative quickly frozen sections. It is helpful for accurate diagnosis by well learning its clinicopathological features and conditions.%目的：探讨后肾腺瘤( metanephric adenoma, MA)的临床病理特
征及诊断、鉴别诊断要点。

方法对收治的1例MA进行回顾性分析并复习相关文献。

结果本例因右上腹疼痛伴恶心、呕吐3 d入院。

经超声、CT、MRI检查初步诊断为右侧肾脏占位性病变,遂行手术治疗。

术中切除一8 cm ×5 cm ×3 c m大小的类圆形肿物,切面呈灰白灰红色,有包膜,与周围组织分界清楚。

术中快速冷冻切片病理检查示：肿瘤细胞较小且大小较一致,胞质少,核无异型性,无病理性核分裂象,瘤细胞呈细乳头状、小管状排列,间质淡染,部分区域水肿,未见胚芽组织及钙化。

术后免疫组织化学染色示：Vimentin、WT1、CD57、CKpan及S-100均(+),Ki67<2%阳性。

诊断为MA,后患者恢复良好出院。

随访4年,病情未复发。

结论 MA是一种少见的肾脏原发上皮源性肿瘤,术中快速冷冻切片病理检查易误诊为肾母细胞瘤,熟悉其临床病理特征有助于准确诊断。

【总页数】3页(P38-40)
【作者】周萍;朱正龙;张伟;戴黄琼;吴艳
【作者单位】225400 江苏泰兴，扬州大学附属泰兴市人民医院病理科;225400
江苏泰兴，扬州大学附属泰兴市人民医院病理科;225400 江苏泰兴，扬州大学附属泰兴市人民医院病理科;225400 江苏泰兴，扬州大学附属泰兴市人民医院病理科;225400 江苏泰兴，扬州大学附属泰兴市人民医院病理科
【正文语种】中文
【中图分类】R737.11
【相关文献】
1.后肾腺瘤误诊为肾癌并文献复习 [J], 刘贤平;王玉林;李红
2.1例易误诊的肺转移性上皮样恶性周围神经鞘膜瘤临床病理分析并文献复习 [J], 王建军;陈雅;史炯;柏涛;王仁庆;樊祥山;孟凡青;牛丰南
3.1例易误诊的肺转移性上皮样恶性周围神经鞘膜瘤临床病理分析并文献复习 [J], 王建军;陈雅;史炯;柏涛;王仁庆;樊祥山;孟凡青;牛丰南;
4.输卵管完全性葡萄胎误诊临床病理分析并文献复习 [J], 罗莹; 王成有; 吴荔香; 祝建芳
5.后肾腺瘤误诊1例并文献复习 [J], 白姣;郑永才;张丽;吴亚玲;雷琳;杨波;彭月享;陈志华;肖彬
因版权原因，仅展示原文概要，查看原文内容请购买。