Fukuzawa Hiroaki, Aoba Takeshi, Yoshida Makiko, Iwafuchi Hideto, Koike Junki, Kitagawa Hiroaki, Urushihara Naoto, Yokoi Akiko, Maeda Kosaku
a Department of Pediatric Surgery , Kobe Children's Hospital , Kobe , Japan.
b Division of Pediatric Surgery , St. Marianna University School of Medicine , Kawasaki , Japan.
Fetal Pediatr Pathol. 2015;34(6):383-90. doi: 10.3109/15513815.2015.1095258. Epub 2015 Oct 16.
To evaluate the pathological features of the primary lesion in patients with relapse of unilateral favorable histology nephroblastoma.
Fifty-eight patients with unilateral favorable histology nephroblastoma who underwent initial nephrectomy before chemotherapy were categorized into one of two groups: the nonrelapsed group (n = 52) and the relapsed group (n = 6). The histological subtypes of both groups and pathological features of the relapsed group were re-evaluated retrospectively.
The histological subtypes of all relapsed cases were classified as blastemal predominant. In three of six cases with relapse, sheets of spindle-shaped blastemal cells that were histologically reminiscent of synovial sarcoma were predominant (massive sarcomatoid pattern).
The histological blastemal predominant subtype of nephroblastoma is a strong indicator of relapse. In particular, the blastemal predominant subtype with massive sarcomatoid pattern may have a higher risk of relapse.
评估单侧预后良好型肾母细胞瘤复发患者原发灶的病理特征。
58例单侧预后良好型肾母细胞瘤患者在化疗前行初始肾切除术，分为两组：未复发组（n = 52）和复发组（n = 6）。回顾性重新评估两组的组织学亚型及复发组的病理特征。
所有复发病例的组织学亚型均为以原始胚基为主型。6例复发患者中有3例，以成片的梭形原始胚基细胞为主，组织学上类似滑膜肉瘤（大量肉瘤样模式）。
肾母细胞瘤组织学上以原始胚基为主型是复发的有力指标。特别是具有大量肉瘤样模式的以原始胚基为主型可能具有更高的复发风险。
