Watanabe Shiho, Naganuma Hiroshi, Shimizu Michio, Ota Satoshi, Murata Shin-Ichi, Nihei Naoki, Matsushima Jun, Mikami Shuji, Kuroda Naoto, Nagashima Yoji, Nakatani Yukio
Departments of Diagnostic Pathology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan.
Case Rep Pathol. 2013;2013:675875. doi: 10.1155/2013/675875. Epub 2013 Sep 3.
Although nephroblastoma is the commonest renal tumor of childhood, it is rare in adults. In cases of predominantly epithelial type occurring in adulthood, it might be difficult to distinguish it from papillary renal cell carcinoma and metanephric adenoma. Here, we report three cases of adult epithelial nephroblastoma in 24-, 76-, and 21-year-old females. Histologically, the tumors were composed of papillotubular architectures of small and uniform tumor cells with high nucleocytoplasmic ratio without blastemal element. Immunohistochemically, the tumor cells were positive for WT-1 and CD57 but negative for AMACR, which was helpful to exclude the possibility of papillary renal cell carcinoma. Metanephric adenoma is a benign tumor, which can be distinguished by the observation of the cellular atypism and growth pattern. However, nephroblastoma with predominant epithelial element mimics the malignant counterpart of metanephric adenoma, that is, "metanephric adenocarcinoma."
尽管肾母细胞瘤是儿童期最常见的肾脏肿瘤，但在成人中却很罕见。在成年期发生的以上皮型为主的病例中，可能难以将其与乳头状肾细胞癌和后肾腺瘤区分开来。在此，我们报告3例成年上皮性肾母细胞瘤病例，患者为24岁、76岁和21岁女性。组织学上，肿瘤由小而均匀的肿瘤细胞组成的乳头管状结构构成，核质比高，无原始胚基成分。免疫组化显示，肿瘤细胞WT-1和CD57阳性，但AMACR阴性，这有助于排除乳头状肾细胞癌的可能性。后肾腺瘤是一种良性肿瘤，可通过观察细胞异型性和生长方式来鉴别。然而，以上皮成分占主导的肾母细胞瘤类似于后肾腺瘤的恶性对应物，即“后肾腺癌”。
