Venkatesh Kusuma, Lamba Saini Monika, Niveditha S R, Krishnagiri Chaithra, Babu Sudarshan
Department of Pathology, Kempegowda Institute of Medical Sciences, Bangalore 560004, India.
Patholog Res Int. 2010 Feb 3;2010:652398. doi: 10.4061/2010/652398.
Primary leiomyosarcoma of the kidney is a rare tumor with an aggressive behaviour. A 55-year-old woman presented with a left sided abdominal mass in our outpatient department. Radiologic investigations revealed the mass to be renal in origin with colonic adhesions for which radical nephrectomy and hemicolectomy were done. The tumor completely appeared to replace the left kidney and had a whorled character focally on cut section. Microscopically, spindle cells having malignant features with cigar shaped nuclei were seen. The smooth muscle origin of the cells was confirmed by immunohistochemical positivity for smooth muscle actin. Sarcomatoid variant of the renal cell carcinoma was ruled out as the tumor was negative for cytokeratin. Tumors with spindle cell morphology in the kidney should not always be taken for a sarcomatoid variant of renal cell carcinoma and should be investigated thoroughly.
原发性肾平滑肌肉瘤是一种具有侵袭性的罕见肿瘤。一名55岁女性在我们门诊部出现左侧腹部肿块。影像学检查显示该肿块起源于肾脏并伴有结肠粘连，为此进行了根治性肾切除术和半结肠切除术。肿瘤似乎完全取代了左肾，在切面局部呈漩涡状。显微镜下，可见具有恶性特征的梭形细胞，核呈雪茄状。通过平滑肌肌动蛋白免疫组化阳性证实细胞起源于平滑肌。由于肿瘤细胞角蛋白阴性，排除了肾细胞癌的肉瘤样变体。肾脏中具有梭形细胞形态的肿瘤不应总是被视为肾细胞癌的肉瘤样变体，而应进行全面检查。
