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多灶性透明细胞乳头状肾细胞癌与肾嗜酸细胞瘤并存:一例报告

Coexistence of multiple clear cell papillary renal cell carcinoma with renal oncocytoma: a case report.

作者信息

Hermi Amine, Saadi Ahmed, Mokadem Seif, Blel Ahlem, Chakroun Marouene, Ben Slama Mohamed Riadh

机构信息

Department of urology.

Department of Pathology, Faculty of Medicine, Faculty Tunis Manar, Charles Nicolle Hospital, Tunis, Tunisia.

出版信息

Ann Med Surg (Lond). 2023 Apr 6;85(5):2017-2019. doi: 10.1097/MS9.0000000000000570. eCollection 2023 May.

Abstract

UNLABELLED

Clear cell papillary renal cell carcinoma (CCPRCC) is a new entity, previously known as unclassified renal cell carcinoma, and initiallly identified in patients suffering of end-stage kidney failure. It is extremely rare to see this new entity associated with others renal malignant lesions.

CASE PRESENTATION

The authors report a case of a female 65-year-old suffering from end-stage kidney failure for 10 years, who presented with a double left renal tumor, composed by an oncocytoma associated to multiple CCPRCC, a very rare entity. A radical left nephrectomy was realized by lumbotomy, with an uneventful postoperative course. Histological examination was challenging. Immunohistological examination showed diffuse positivity of cytokertain 7. No local recurrence nor metastatic progression were found during the 12 months of follow-up.

CLINICAL DISCUSSION

CCPRCC, is a new entity, previously known as the unclassified rena cell carcinoma, is a malignant renal tumor, initially reported in patients at end-stage kidney failure. Oncocytoma is a well-known rare benign renal tumor. The association of both is rare, and should be kept in mind, especially when scanoguided diagnosis biopsy is realized. Histopathological confirmation may be challenging, given the recent identification of CCPRCC. The nuclei disposal toward the luminal surface is a characteristic pathological landmark of CCPRCC. Immunohistopathological examination is of great help, showing a distinctive profile: diffuse staining for cytokertain 7 and carbonic anhydrase IX.

CONCLUSION

CCPRCC is a new malignant pathological entity in renal tumors. It can be associated with other benign renal lesions. This should be taken into consideration while histopathological examination, mainly of scanoguided biopsy cores.

摘要

未标注

透明细胞乳头状肾细胞癌(CCPRCC)是一种新的实体瘤,以前被称为未分类肾细胞癌,最初在终末期肾衰竭患者中被发现。这种新实体瘤与其他肾恶性病变相关极为罕见。

病例报告

作者报告一例65岁女性,患有终末期肾衰竭10年,其左肾出现双肿瘤,由嗜酸性细胞瘤与多个CCPRCC组成,这是一种非常罕见的情况。通过腰部切口进行了根治性左肾切除术,术后过程顺利。组织学检查颇具挑战性。免疫组织学检查显示细胞角蛋白7弥漫性阳性。在12个月的随访中未发现局部复发或转移进展。

临床讨论

CCPRCC是一种新的实体瘤,以前被称为未分类肾细胞癌,是一种恶性肾肿瘤,最初在终末期肾衰竭患者中报道。嗜酸性细胞瘤是一种众所周知的罕见良性肾肿瘤。两者的关联罕见,应予以关注,尤其是在进行超声引导下诊断性活检时。鉴于CCPRCC是最近才被认识的,组织病理学确诊可能具有挑战性。细胞核朝向管腔表面排列是CCPRCC的一个特征性病理标志。免疫组织病理学检查有很大帮助,显示出独特的特征:细胞角蛋白7和碳酸酐酶IX弥漫性染色。

结论

CCPRCC是肾肿瘤中的一种新的恶性病理实体。它可与其他良性肾病变相关。在组织病理学检查时,主要是对超声引导下活检组织芯进行检查时应考虑到这一点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81f5/10205370/c8f4e916de8e/ms9-85-2017-g001.jpg

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