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黏液性管状和梭形细胞肾细胞癌的综合影像-病理诊断与治疗概述:一例报告及文献系统综述

Integrated Imaging-Pathologic Diagnosis and Treatment Overview of Mucinous Tubular and Spindle Cell Renal Cell Carcinoma: A Case Report and Systematic Review of the Literature.

作者信息

Zhang Yu, Long Yu, Wang Jie

机构信息

Department of Pathology, Hangzhou Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medicine University, Hangzhou, China.

出版信息

Case Rep Oncol. 2024 Dec 18;18(1):346-352. doi: 10.1159/000543004. eCollection 2025 Jan-Dec.

Abstract

INTRODUCTION

Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney is a rare, low-grade renal epithelial tumor with a unique histopathological profile. This case report aimed to highlight the clinical, imaging, and immunohistochemical features of MTSCC, facilitating its differentiation from other renal tumors and providing insight into effective management strategies.

CASE PRESENTATION

A 52-year-old female presented with left-sided abdominal pain. Imaging studies, including CT and ultrasound, revealed a low-density mass in the left kidney. The patient subsequently underwent laparoscopic radical nephrectomy. Pathological examination identified spindle and cuboidal epithelial cells forming elongated tubules with mild atypia within a mucinous stroma. Immunohistochemical staining showed positivity for CK7, P504S, and PAX8, confirming the diagnosis of MTSCC. Postoperatively, the patient was managed conservatively without chemotherapy or radiotherapy and received only symptomatic treatment. During a 24-month follow-up, she demonstrated favorable recovery with no signs of recurrence or metastasis.

CONCLUSION

This case underscores the critical role of imaging, histopathology, and immunohistochemistry in accurately diagnosing MTSCC. Early detection and timely surgical intervention can lead to positive outcomes, as illustrated by this patient's recovery. Further research is needed to explore the molecular mechanisms of MTSCC and establish robust guidelines for its management.

摘要

引言

肾黏液性小管和梭形细胞癌(MTSCC)是一种罕见的低级别肾上皮性肿瘤,具有独特的组织病理学特征。本病例报告旨在突出MTSCC的临床、影像学和免疫组化特征,有助于将其与其他肾肿瘤相鉴别,并为有效的管理策略提供见解。

病例介绍

一名52岁女性因左侧腹痛就诊。包括CT和超声在内的影像学检查显示左肾有一个低密度肿块。该患者随后接受了腹腔镜根治性肾切除术。病理检查发现梭形和立方形上皮细胞在黏液性间质内形成细长小管,伴有轻度异型性。免疫组化染色显示CK7、P504S和PAX8呈阳性,确诊为MTSCC。术后,患者接受保守治疗,未进行化疗或放疗,仅接受对症治疗。在24个月的随访期间,她恢复良好,无复发或转移迹象。

结论

本病例强调了影像学、组织病理学和免疫组化在准确诊断MTSCC中的关键作用。如该患者的恢复情况所示,早期发现和及时的手术干预可带来良好的结果。需要进一步研究以探索MTSCC的分子机制,并建立其管理的有力指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd10/11913464/197458770bad/cro-2025-0018-0001-543004_F01.jpg

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