Kushima Hisako, Ishii Hiroshi, Kinoshita Yoshiaki, Fujita Masaki, Watanabe Kentaro
Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, 814-0180, Japan.
Department of Pathology, Fukuoka University Hospital, Fukuoka, 814-0180, Japan.
Respir Med Case Rep. 2018 Mar 27;24:30-31. doi: 10.1016/j.rmcr.2018.03.014. eCollection 2018.
A 91-year-old woman was admitted with persistent pyrexia, anorexia and weight loss. A chest radiograph showed multiple circular masses of various sizes. Chest computed tomography revealed multiple pleural tumors without any lung lesion. The ultrasound-guided biopsy specimens demonstrated diffusely-proliferated tumor cells with clear or vacuolated cytoplasm, which were positive for CD10, PAX8, vimentin and CAM5.2, but were negative for mesothelial cell markers such as HBME-1 and thrombomodulin. These findings indicated metastatic clear cell carcinoma of the kidney, and a solitary renal tumor was observed on abdominal computed tomography. It has been reported that pleural metastases constituted 12% of patients with progressive renal cell carcinoma, and most of the pleural metastases occurred secondary to lung metastasis. This was a rare case of renal cell carcinoma with an unusual chest image via an intriguing metastatic pathway, which was limited to pleura.
一名91岁女性因持续发热、厌食和体重减轻入院。胸部X线片显示多个大小不一的圆形肿块。胸部计算机断层扫描显示多个胸膜肿瘤，无任何肺部病变。超声引导下活检标本显示肿瘤细胞弥漫性增殖，细胞质清晰或有空泡，CD10、PAX8、波形蛋白和CAM5.2呈阳性，但间皮细胞标志物如HBME-1和血栓调节蛋白呈阴性。这些发现提示为肾转移性透明细胞癌，腹部计算机断层扫描观察到一个孤立性肾肿瘤。据报道，胸膜转移占进展期肾细胞癌患者的12%，大多数胸膜转移继发于肺转移。这是一例罕见的肾细胞癌，通过一种有趣的转移途径表现出不寻常的胸部影像，且仅局限于胸膜。
