Kuroda Naoto, Katto Kazunobu, Tamura Masato, Shiotsu Tomoyuki, Hes Ondrej, Michal Michal, Nagashima Yoji, Ohara Masahiko, Hirouchi Takashi, Mizuno Keiko, Hayashi Yoshihiro, Lee Gang-Hong
Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi City, Japan.
Pathol Int. 2008 Jan;58(1):51-4. doi: 10.1111/j.1440-1827.2007.02188.x.
Carcinoid tumor of the renal pelvis is an extremely rare neoplasm and only two cases have been previously reported in the English-language literature. Reported herein is a third case of carcinoid tumor arising in the renal pelvis. The tumor extending from the left renal pelvis into the left kidney was incidentally found in a 55-year-old Japanese woman. Macroscopically, the tumor was predominantly located in the dilated renal pelvis and was grayish-white on cut surface. Microscopically, neoplastic cells proliferated with a ribbon-like, trabecular, tubular and solid pattern. Furthermore, the tumor focally invaded the kidney parenchyma. No precursor lesion of neuroendocrine tumor was observed in the peripheral urothelial epithelium. Neither urothelial carcinoma nor teratoma component was observed within the tumorous mass. The cytoplasm of neoplastic cells was focally positive for Grimelius stain and focally positive for chromogranin A and synaptophysin. However, no neoplastic cells reacted with cytokeratins 7 and 20. Ultrastructurally, neoplastic cells contained dense core granules in the cytoplasm. Urologists and pathologists should recognize that carcinoid tumor may arise from the renal pelvis.
肾盂类癌是一种极其罕见的肿瘤，此前英文文献中仅报道过两例。本文报告的是第三例起源于肾盂的类癌。该肿瘤从左肾盂延伸至左肾，是在一名55岁日本女性中偶然发现的。大体上，肿瘤主要位于扩张的肾盂内，切面呈灰白色。显微镜下，肿瘤细胞呈带状、小梁状、管状和实性模式增殖。此外，肿瘤局部侵犯肾实质。在周围尿路上皮中未观察到神经内分泌肿瘤的前驱病变。肿瘤块内未观察到尿路上皮癌或畸胎瘤成分。肿瘤细胞的细胞质对Grimelius染色呈局灶性阳性，对嗜铬粒蛋白A和突触素呈局灶性阳性。然而，没有肿瘤细胞与细胞角蛋白7和20发生反应。超微结构上，肿瘤细胞的细胞质中含有致密核心颗粒。泌尿外科医生和病理科医生应认识到类癌可能起源于肾盂。
