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肾脏血管平滑肌脂肪瘤—52 例临床病理分析。

Angiomyolipoma of the kidney-Clinicopathological analysis of 52 cases.

机构信息

Department of Radiology, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.

Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.

出版信息

Pathol Oncol Res. 2023 Jan 9;28:1610831. doi: 10.3389/pore.2022.1610831. eCollection 2022.

Abstract

The renal angiomyolipoma (AML) is a benign tumor characteristically composed of fat, smooth muscle tissue, and vessels. We collected AMLs from our nephrectomy database, reclassified them according to their histological appearance, recorded the demographic, clinical, and pathological parameters, and compared them with oncocytoma (RO) and renal cell carcinoma (RCC). Immunohistochemistry was ordered in 41 cases. In 2224 nephrectomies, we found 52 AMLs with a 53 mm median size. The mean age was 52.76. Forty-eight tumors were sporadic, while four were hereditary. The revision resulted in 31 classic, 13 leiomyoma-like, five lipoma-like, two epithelioid, and one AML with epithelial cysts. SMA was diffusely positive, except for the epithelioid type, while MelanA harbored stronger expression than HMB45. AML was more frequent in females and appeared ten and 7 years earlier than RO and RCC, respectively. The follow-up time was 7.42 years, and neither tumor-related death nor relapse occurred. AML is rare in nephrectomies and develops primarily in females in their 50s with an average size of 50-60 mm at the surgery. The histological appearance in order of frequency is classic, leiomyoma-like, lipoma-like, epithelioid, and cystic. The MelanA, HMB45, and SMA immunohistochemistry can support the light-microscopic findings.

摘要

肾血管平滑肌脂肪瘤(AML)是一种良性肿瘤,特征性地由脂肪、平滑肌组织和血管组成。我们从肾切除术数据库中收集了 AML,并根据其组织学表现进行重新分类,记录了人口统计学、临床和病理参数,并将其与嗜酸细胞瘤(RO)和肾细胞癌(RCC)进行了比较。对 41 例进行了免疫组织化学检查。在 2224 例肾切除术中,我们发现了 52 个 AML,中位大小为 53 毫米。平均年龄为 52.76 岁。48 个肿瘤为散发性,而 4 个为遗传性。修订后,31 个为经典型,13 个为平滑肌瘤样,5 个为脂肪瘤样,2 个为上皮样,1 个为含有上皮样囊肿的 AML。SMA 弥漫阳性,除上皮样型外,而 MelanA 比 HMB45 表达更强。AML 在女性中更为常见,比 RO 和 RCC 分别早出现 10 年和 7 年。随访时间为 7.42 年,均未发生肿瘤相关死亡或复发。AML 在肾切除术中很少见,主要发生在 50 多岁的女性中,手术时平均大小为 50-60 毫米。组织学表现依次为经典型、平滑肌瘤样、脂肪瘤样、上皮样和囊性。MelanA、HMB45 和 SMA 免疫组织化学检查可以支持光镜下的发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da73/9868137/7da72c057af5/pore-28-1610831-g001.jpg

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