Hou Jun, Xu Jian-Fang, Ji Yuan, Hou Ying-Yong, Tan Yun-Shan, Sujie Akesu, Xu Lei, Shi Da-Ren
Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Zhonghua Bing Li Xue Za Zhi. 2010 Dec;39(12):825-9.
To study the pathologic features and immunophenotype of 3 cases of melanotic epithelioid clear cell tumor of kidney.
More than 2000 cases of renal tumors were retrospectively reviewed. Three cases of melanotic epithelioid clear cell tumor were identified. Immunohistochemical study was carried out using the paraffin-embedded tissue samples. Electron microscopy was also performed in 1 case.
Amongst the 3 cases studied, the male-to-female ratio is 1:2. Histologically, 2 cases showed a clear cell carcinoma-like pattern. Papillary structures covered by clear cells and eosinophilic cells were observed in 1 case. Immunohistochemical study showed that the tumor cells in all cases expressed HMB 45. Two of them were also positive for Melan A. The staining for epithelial markers and S-100 protein was negative. Melanosomes were not identified by ultrastructural examination.
Melanotic epithelioid clear cell tumor is a rarely seen neoplasm of kidney. There are some histologic overlaps with renal cell carcinoma, epithelioid angiomyolipoma and melanoma. Immunohistochemical study is useful in confirming the diagnosis. The tumor represents a morphologic variant of epithelioid angiomyolipoma.
研究3例肾黑素性上皮样透明细胞肿瘤的病理特征及免疫表型。
回顾性分析2000余例肾肿瘤病例。共识别出3例黑素性上皮样透明细胞肿瘤。对石蜡包埋组织样本进行免疫组织化学研究。其中1例还进行了电子显微镜检查。
在研究的3例病例中，男女比例为1:2。组织学上，2例表现为透明细胞癌样模式。1例观察到由透明细胞和嗜酸性细胞覆盖的乳头结构。免疫组织化学研究显示，所有病例的肿瘤细胞均表达HMB 45。其中2例Melan A也呈阳性。上皮标志物和S-100蛋白染色均为阴性。超微结构检查未发现黑素小体。
黑素性上皮样透明细胞肿瘤是一种罕见的肾肿瘤。与肾细胞癌、上皮样血管平滑肌脂肪瘤和黑色素瘤存在一些组织学重叠。免疫组织化学研究有助于确诊。该肿瘤代表上皮样血管平滑肌脂肪瘤的一种形态学变异型。
