Méndez Gonzalo P, Klock Clóvis, Nosé Vânia
Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Int J Surg Pathol. 2011 Feb;19(1):93-8. doi: 10.1177/1066896908329413. Epub 2008 Dec 18.
This study presents a case of juxtaglomerular cell tumor (JCT) in a 12-year-old girl with hypertension. Fine needle aspirate (FNA) cytology demonstrated a neoplasm with features of a papillary carcinoma, prompting a right radical nephrectomy. Histological examination revealed solid sheets of round epithelioid cells with eosinophilic granular cytoplasm, and distinct cell borders in a background of widespread hemorrhage. Electron microscopy revealed cytoplasmic renin granules. The differential diagnosis of a renal mass in a young patient with hypertension includes JCT, Wilm's tumor, and renal cell carcinoma, which may produce renin. The renin granules detected by electron microscopy are characteristic of JCT, and the diagnosis is confirmed by ultrastructural study. FNA cytology is not sensitive enough for the diagnosis of JCT and its results must be carefully interpreted.
本研究报告了一例12岁患高血压女孩的近球旁细胞瘤（JCT）。细针穿刺抽吸（FNA）细胞学检查显示肿瘤具有乳头状癌的特征，遂行右肾根治性切除术。组织学检查发现实性片状圆形上皮样细胞，胞质嗜酸性颗粒状，在广泛出血背景下细胞边界清晰。电子显微镜检查发现胞质肾素颗粒。年轻高血压患者肾肿块的鉴别诊断包括JCT、肾母细胞瘤和肾细胞癌，这些肿瘤可能产生肾素。电子显微镜检测到的肾素颗粒是JCT的特征，超微结构研究证实了诊断。FNA细胞学对JCT的诊断不够敏感，其结果必须仔细解读。
