Koie Takuya, Yoneyama Takahiro, Hashimoto Yasuhiro, Kamimura Noritaka, Kusumi Tomomi, Kijima Hiroshi, Ohyama Chikara
Department of Urology, Hirosaki University Graduate School of Medicine, Zaifuchou, Hirosaki, Japan.
Int J Urol. 2009 Mar;16(3):333-5. doi: 10.1111/j.1442-2042.2008.02231.x.
Cases of renal cell carcinoma (RCC) associated with Xp11 translocations are rare and are reported predominantly in children. We report a case of a young man who developed an aggressive Xp11 translocation RCC. A 28-year-old man presented with back pain, fever and macroscopic hematuria. Computed tomography of the abdomen showed a heterogeneous mass in the left kidney. Left radical nephrectomy was performed. Hematoxylin-eosin staining revealed nested and papillary architecture, clear and eosinophilic cytoplasm and vesicles with prominent nucleoli. Immunohistochemical evaluation revealed that the tumor cells showed nuclear labeling for TFE3 protein. On the basis of these findings, the case was diagnosed as Xp11 translocation RCC. This tumor massively recurred and led to the patient's death 2 years after the initial diagnosis. The utility of immunohistochemistry using antibodies against TFE3 in RCC occurring in young adults may be necessary for accurate diagnosis.
与Xp11易位相关的肾细胞癌(RCC)病例罕见,主要报道于儿童。我们报告一例发生侵袭性Xp11易位肾细胞癌的年轻男性病例。一名28岁男性出现背痛、发热和肉眼血尿。腹部计算机断层扫描显示左肾有一不均匀肿块。行左肾根治性切除术。苏木精-伊红染色显示呈巢状和乳头状结构,细胞质透明且嗜酸性,有含明显核仁的囊泡。免疫组织化学评估显示肿瘤细胞TFE3蛋白呈核标记。基于这些发现,该病例被诊断为Xp11易位肾细胞癌。该肿瘤在初次诊断后2年大量复发并导致患者死亡。对于准确诊断,在年轻成人发生的肾细胞癌中使用抗TFE3抗体进行免疫组织化学检查可能是必要的。