Bird D J, Semple J P, Seiler M W
Department of Veterans Affairs Medical Center, West Roxbury, Massachusetts 02132.
Ultrastruct Pathol. 1991 Jul-Oct;15(4-5):361-6. doi: 10.3109/01913129109016245.
An unusual case of metastatic sarcomatoid renal cell carcinoma is presented. Fifteen months after nephrectomy for a typical clear cell carcinoma, a 63-year-old man presented with bilateral pleural effusions, cardiomegaly, and tamponade. A pericardial biopsy showed an anaplastic spindle cell tumor that was strongly keratin positive and showed desmosomes ultrastructurally. The patient died shortly thereafter, and the autopsy revealed massive tumor infiltration of the heart, pulmonary and adrenal metastases, and tumor nodules at the incision site of his nephrectomy. The differential diagnosis of sarcomatoid renal cell carcinoma is discussed.
本文报告了一例罕见的转移性肉瘤样肾细胞癌病例。一名63岁男性在因典型透明细胞癌行肾切除术后15个月，出现双侧胸腔积液、心脏扩大和心包填塞。心包活检显示为间变性梭形细胞瘤，角蛋白强阳性，超微结构显示有桥粒。患者此后不久死亡，尸检发现心脏有大量肿瘤浸润、肺和肾上腺转移以及肾切除切口部位有肿瘤结节。文中讨论了肉瘤样肾细胞癌的鉴别诊断。
