Tan Guobin, Liu Lei, Qiu Mingning, Chen Lieqian, Cao Jun, Liu Jianjun
Laboratory of Urologic Surgery, Affiliated Hospital of Guangdong Medical College Zhanjiang 524001, China.
Int J Clin Exp Pathol. 2015 Jan 1;8(1):1077-80. eCollection 2015.
Epithelioid angiomyolipoma (EAML) is a rare renal mesenchymal tumor with malignant potential and is frequently associated with tuberous sclerosis complex (TSC). As metastasis of the tumor cells occur early, EAML is considered a potentially malignant tumor type and intrigues further research on it. Under the microscope, we could find the tumor was composed of atypical polygonal cells sheet mixed with classic angiomyolipoma (AML) components such as blood vessels with notable thick vascular walls, smooth muscle-like cells and adipocytes. Immunohistochemical studies showed that epithelioid cells were focally positive for vimentin, melanocytic markers (HMB-45), myoid markers (α-smooth muscle actin), CD34 and CD68; negative for cytokeratin, epithelial membrane antigen, CD10, and S-100. And the Ki67 index showed approximately 3%. Here, we report the morphological and immunohistochemical features of clinically or histologically malignant renal EAML and discuss its diagnosis, differential diagnosis and the prognosis.
上皮样血管平滑肌脂肪瘤(EAML)是一种罕见的具有恶性潜能的肾间叶肿瘤,常与结节性硬化症(TSC)相关。由于肿瘤细胞早期发生转移,EAML被认为是一种潜在的恶性肿瘤类型,引发了对其进一步的研究。在显微镜下,我们可以发现肿瘤由非典型多边形细胞片组成,混合有经典血管平滑肌脂肪瘤(AML)成分,如血管壁明显增厚的血管、平滑肌样细胞和脂肪细胞。免疫组织化学研究表明,上皮样细胞局灶性表达波形蛋白、黑素细胞标志物(HMB-45)、肌样标志物(α-平滑肌肌动蛋白)、CD34和CD68;细胞角蛋白、上皮膜抗原、CD10和S-100呈阴性。Ki67指数约为3%。在此,我们报告临床或组织学上恶性肾EAML的形态学和免疫组织化学特征,并讨论其诊断、鉴别诊断和预后。