Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea.
J Korean Med Sci. 2010 May;25(5):785-9. doi: 10.3346/jkms.2010.25.5.785. Epub 2010 Apr 16.
Multicystic dysplastic kidney (MCDK) is a relatively common developmental anomaly in infants and children and has a good prognosis. In contrast, a malignant rhabdoid tumor of the kidney (MRTK) is one of the most lethal neoplasms of early life. However, the presentation of such a lethal tumor combined with multicystic dysplasia has not been reported to date. In this report, we describe a case of MRTK in a 5-yr-old girl who also had multicystic dysplasia. She was previously diagnosed with MCDK at birth due to a huge palpable mass on the right side of the abdomen. The right kidney was extensively replaced by numerous grossly dilated, variable-sized cysts. Microscopically, the tumor cells show a diffusely infiltrative growth pattern, which revealed large non-cohesive, round-to-polygonal tumor cells with vesicular nuclei. Some tumor cells had eccentric nuclei and large, round, eosinophilic cytoplasmic inclusions. There were metanephrons present, with the central ureteric bud and peripheral branches surrounded by condensing mesenchyma, immature glomeruli, and metaplastic cartilage in the adjacent parenchyma. To our knowledge, this is the first combined case of the two aforementioned diseases and this case may, in fact, suggest a new disease entity.
多囊性发育不良肾(MCDK)是婴儿和儿童中相对常见的发育异常,预后良好。相比之下,肾横纹肌样瘤(MRTK)是生命早期最致命的肿瘤之一。然而,迄今尚未报道如此致命的肿瘤与多囊性发育不良同时存在的情况。在本报告中,我们描述了一例 5 岁女孩的 MRTK,她还患有多囊性发育不良。她出生时因右侧腹部有巨大可触及的肿块而被诊断为 MCDK。右肾被大量明显扩张的、大小不一的囊肿广泛取代。显微镜下,肿瘤细胞呈弥漫浸润性生长模式,显示出大的非黏附性、圆形至多边形的肿瘤细胞,具有泡状核。一些肿瘤细胞具有偏心核和大的、圆形、嗜酸性细胞质内包涵体。存在嗜铬细胞,中央输尿管芽和外周分支被浓缩的间充质、不成熟的肾小球和相邻实质中的间变软骨所包围。据我们所知,这是这两种上述疾病的首例联合病例,该病例实际上可能提示一种新的疾病实体。