Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-4009, USA.
Hum Pathol. 2011 Jan;42(1):146-50. doi: 10.1016/j.humpath.2010.01.026. Epub 2010 Oct 23.
Thyroid-like follicular carcinoma of the kidney is an extremely rare variant of renal cell carcinoma. Most previously reported cases presented as incidental small tumors confined to the kidney. Here we report a unique case in which the patient presented with flank pain and hematuria. Imaging studies demonstrated a large tumor in the right kidney and metastases to the lungs and retroperitoneal lymph nodes. Both the renal tumor and the sampled lung metastasis were composed almost entirely of follicles with dense, colloid-like material resembling thyroid follicular carcinoma. However, no lesion was found in the thyroid gland; and the patient's thyroid function test results were normal. The tumor cells were immunoreactive for PAX2 and PAX8 but lacked reactivity for thyroglobulin and thyroid transcription factor-1. To our knowledge, this is the first case of thyroid-like follicular carcinoma of the kidney to be initially associated with marked symptoms and widespread metastases, providing evidence that this rare variant of renal cell carcinoma can be clinically aggressive.
肾脏甲状腺样滤泡癌是一种极为罕见的肾细胞癌亚型。既往大多数报道的病例表现为偶然发现的局限于肾脏的小肿瘤。在此我们报告一例特殊病例，该患者以腰痛和血尿为主要表现。影像学检查显示右肾内有一巨大肿瘤，并伴有肺部和腹膜后淋巴结转移。肾脏肿瘤和取样的肺转移灶几乎完全由滤泡组成，其内充满类似甲状腺滤泡癌的浓密胶样物质。然而，甲状腺并未发现病灶；且患者的甲状腺功能检查结果正常。肿瘤细胞对 PAX2 和 PAX8 呈免疫反应性，但缺乏对甲状腺球蛋白和甲状腺转录因子-1 的反应性。据我们所知，这是首例最初表现为明显症状和广泛转移的肾脏甲状腺样滤泡癌，这表明这种罕见的肾细胞癌亚型可能具有临床侵袭性。
