Kuroda N, Inoue Y, Taguchi T, Tominaga A, Hes O, Michal M, Hayashi Y, Hiroi M, Shuin T, Lee G H
Department of Pathology and Laboratory Medicine, Kochi Red Cross Hospital, Kochi, Japan.
Histol Histopathol. 2007 Aug;22(8):883-8. doi: 10.14670/HH-22.883.
Renal leiomyoma is a rare neoplasm. We report such a case in a 57-year-old Japanese woman who was found to have a mass in the left kidney. The histological examination disclosed the proliferation of spindle cells showing a benign appearance. Entrapped tubular cells were observed in the peripheral area of the tumor. The immunohistochemical examination of spindle neoplastic cells showed a positive reaction for alpha smooth muscle actin, h-caldesmon, l-caldesmon, calponin, muscle actin, myosin and desmin. Additionally, the ultrastructural examination of the tumor showed membrane caveolae and myofilaments in the cytoplasm. This tumor was considered to show a differentiation into smooth muscle cells. The comparative genomic hybridization of the tumor detected the combined losses of chromosomes 4, 6, 12 and 14 which has not been previously described in renal tumors. Finally, the immunohistochemical panel of smooth muscle markers and ultrastructural and genetic study may be useful in diagnosing renal leiomyoma.
肾平滑肌瘤是一种罕见的肿瘤。我们报告了一例57岁的日本女性病例，该患者左肾发现有一个肿块。组织学检查显示梭形细胞增生，呈良性外观。在肿瘤周边区域观察到包绕的肾小管细胞。对梭形肿瘤细胞进行免疫组化检查，结果显示α平滑肌肌动蛋白、h-钙调蛋白、l-钙调蛋白、钙结合蛋白、肌动蛋白、肌球蛋白和结蛋白呈阳性反应。此外，对肿瘤进行超微结构检查，发现细胞质中有膜小窝和肌丝。该肿瘤被认为表现出向平滑肌细胞的分化。对该肿瘤进行比较基因组杂交检测，发现4号、6号、12号和14号染色体存在联合缺失，这在肾肿瘤中此前未见报道。最后，平滑肌标志物的免疫组化检测以及超微结构和遗传学研究可能有助于肾平滑肌瘤的诊断。
