Delongchamps Nicolas B, Galmiche Louise, Eiss David, Rouach Yannick, Vogt Benoit, Timsit Marc-Olivier, Vieillefond Annick, Méjean Arnaud
Department of Pathology, Necker Hospital, University of Paris-René Descartes, Paris, France.
BJU Int. 2009 May;103(10):1381-4. doi: 10.1111/j.1464-410X.2008.08263.x. Epub 2009 Jan 20.
To determine whether renal hybrid tumours (HT) appear as a specific clinical and radiological entity, as HT are characterized by the association of both oncocytes and chromophobe cells within the same tumour, and have been described in patients with oncocytosis and Birt-Hogg-Dube syndrome.
We reviewed the medical charts of 67 patients who had a partial or radical nephrectomy in our institution for renal oncocytoma (RO, 24), chromophobe renal cell carcinoma (CRCC, 36) and HT (seven), from January 2006 to October 2007. We report the clinical, radiological and pathological characteristics of the seven cases of HT.
The mean (range) age of the patients was 56 (41-68) year. None of the seven patients had any suspicion of RO, based on computed tomography (CT). Two patients had a history of kidney cancer. Five patients had partial and two a radical nephrectomy. The mean (range) maximum tumour diameter was 5.5 (1.8-9) cm. Two tumours were pT1a, two were pT1b and three were pT2. Pathological analysis showed RO-like and CRCC-like cells intermixed (six patients) or distinct (one). After a median (range) follow-up of 20 (8-25) months, none of the patients had any evidence of disease recurrence.
In a large series of patients with sporadic RO and CRCC, 10% of the tumours had hybrid morphological features, as described in oncocytosis and Birt-Hogg-Dube syndrome. We were unable to identify any specific clinical characteristic. Most importantly, none of these HT showed any of the radiological characteristics of RO.
确定肾混合性肿瘤(HT)是否表现为一种特定的临床和影像学实体,因为HT的特征是在同一肿瘤内同时存在嗜酸性细胞和嫌色细胞,并且在嗜酸性细胞增多症和Birt-Hogg-Dube综合征患者中已有描述。
我们回顾了2006年1月至2007年10月在我院接受部分或根治性肾切除术的67例患者的病历,这些患者分别患有肾嗜酸细胞瘤(RO,24例)、嫌色肾细胞癌(CRCC,36例)和HT(7例)。我们报告了7例HT的临床、影像学和病理特征。
患者的平均(范围)年龄为56(41 - 68)岁。基于计算机断层扫描(CT),7例患者中无一例被怀疑患有RO。2例患者有肾癌病史。5例患者接受了部分肾切除术,2例接受了根治性肾切除术。肿瘤最大直径的平均(范围)为5.5(1.8 - 9)cm。2个肿瘤为pT1a,2个为pT1b,3个为pT2。病理分析显示RO样细胞和CRCC样细胞混合(6例患者)或分离(1例)。经过中位(范围)20(8 - 25)个月的随访,所有患者均无疾病复发迹象。
在一大组散发性RO和CRCC患者中,10%的肿瘤具有混合形态特征,如嗜酸性细胞增多症和Birt-Hogg-Dube综合征中所描述的那样。我们无法识别任何特定的临床特征。最重要的是,这些HT均未表现出RO的任何影像学特征。