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甲状腺滤泡状癌样肾肿瘤:一例报告及文献复习

Thyroid follicular carcinoma-like renal tumor: A case report and literature review.

作者信息

Zhang Yujie, Yang Jing, Zhang Mingfang, Meng Zhaowei, Song Wenjing, Yang Long, Li Liming, Wang Dan, Shi Tao

机构信息

Department of Pathology, Tianjin Medical University General Hospital Department of Pathology, Tianjin Medical University Department of Pathology, Tianjin First Center Hospital Department of Nuclear Medicine Department of Urinary Surgery, Tianjin Medical University General Hospital, Tianjin, China.

出版信息

Medicine (Baltimore). 2018 May;97(21):e10815. doi: 10.1097/MD.0000000000010815.

Abstract

RATIONALE

Thyroid follicular carcinoma-like renal tumor (TFCLRT) is a rare primary renal epithelial tumor that was first reported in 2006. We report a case diagnosed of TFCLRT by us to observe the pathological feature and analyze comparatively the clinical and pathologic characteristics with all cases of reviewed literatures.

PATIENT CONCERNS

A 54-year-old female patient had the urinary frequency with the symptom of right flank pain with a history of more than half a year of hypertension and received uterine fibroid resection 12 years ago. B-mode ultrasound examination and renal magnetic resonance showed a right renal sinus nodule.

DIAGNOSES

Histopathology revealed thyroid follicle-like structures of different sizes, containing a colloid-like substance, while the periodic acid-Schiff (PAS) and diastase-resistant PAS staining confirmed that it was mucus protein. Immunohistochemical staining showed that it expresses the transcription factor PAX-8 but does not express the thyroid-specific antibodies TG and TTF-1.

INTERVENTIONS

The patient underwent a tumor enucleation of right kidney. No other treatment was conducted after surgery.

OUTCOMES

No metastases to lymph nodes and other organs were found, and 9-months of follow-up did not reveal any tumor progression.

LESSONS

We should differentially diagnose the renal metastasis of thyroid follicular carcinoma or papillary carcinoma. Some related literatures reported that the tumour cells had significant heteromorphism, several of which metastasized to lymph nodes or distal organs. Its biological behavior need to be studied intensively by further expanding the number of cases.

摘要

原理

甲状腺滤泡癌样肾肿瘤(TFCLRT)是一种罕见的原发性肾上皮肿瘤,于2006年首次报道。我们报告一例由我们诊断的TFCLRT病例,以观察其病理特征,并与所有已复习文献中的病例进行临床和病理特征的比较分析。

患者情况

一名54岁女性患者有尿频症状,并伴有右胁腹疼痛,有半年以上高血压病史,12年前接受过子宫肌瘤切除术。B超检查和肾脏磁共振成像显示右肾窦有一个结节。

诊断

组织病理学显示大小不同的甲状腺滤泡样结构,含有类胶质样物质;而高碘酸-希夫(PAS)染色及抗淀粉酶PAS染色证实其为黏液蛋白。免疫组化染色显示其表达转录因子PAX-8,但不表达甲状腺特异性抗体TG和TTF-1。

干预措施

患者接受了右肾肿瘤剜除术。术后未进行其他治疗。

结果

未发现有淋巴结及其他器官转移,9个月的随访未发现任何肿瘤进展。

经验教训

我们应鉴别诊断甲状腺滤泡癌或乳头状癌的肾转移。一些相关文献报道肿瘤细胞有明显异型性,其中一些转移至淋巴结或远处器官。需要通过进一步扩大病例数来深入研究其生物学行为。

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