与转移性肾细胞癌中免疫检查点抑制剂相关的结节病样反应（SLR）
Sarcoid-Like Reaction (SLR) Associated With Immune Checkpoint Inhibitors in Metastatic Renal Cell Carcinoma.
作者信息
Fukushima Kanta, Mizukoshi Sota, Ino Tomohiro, Ishida Takuya, Ito Yumika, Okimura Akira, Nakatsugawa Munehide, Hashimoto Takeshi
机构信息
Department of Urology Tokyo Medical University Hachioji Medical Center Tokyo Japan.
Department of Urology Tokyo Medical University Tokyo Japan.
出版信息
IJU Case Rep. 2025 Apr 14;8(3):285-288. doi: 10.1002/iju5.70027. eCollection 2025 May.
INTRODUCTION
Immune checkpoint inhibitors (ICIs) are useful in the treatment of metastatic renal cell carcinoma. ICIs have been associated with a variety of immune-related adverse events (irAEs), one of which is a sarcoid-like reaction (SLR). SLR is often difficult to distinguish from cancer progression.
CASE PRESENTATION
The patient is a 71-year-old woman. She underwent laparoscopic nephrectomy after 4 courses of ipilimumab + nivolumab therapy for clear cell renal cell carcinoma with femoral bone metastasis. In the pathological examination, in addition to tumor-infiltrating lymphocytes, numerous non-caseating epithelioid cell granulomas were found in the tumor. The occurrence of non-caseating epithelioid cell granuloma in a patient who did not meet the diagnostic criteria for systemic sarcoidosis was considered SLR due to ICI.
CONCLUSIONS
We report the first case of a patient who underwent surgery for metastatic renal cell carcinoma after treatment with ICI and who was pathologically diagnosed with SLR in the kidney.
引言
免疫检查点抑制剂（ICIs）在转移性肾细胞癌的治疗中很有用。ICIs与多种免疫相关不良事件（irAEs）有关，其中之一是类肉瘤样反应（SLR）。SLR常常难以与癌症进展相区分。
病例介绍
该患者为一名71岁女性。她因伴股骨转移的透明细胞肾细胞癌接受了4个疗程的伊匹单抗+纳武单抗治疗后，接受了腹腔镜肾切除术。在病理检查中，除了肿瘤浸润淋巴细胞外，在肿瘤中还发现了大量非干酪样上皮样细胞肉芽肿。在一名不符合系统性结节病诊断标准的患者中出现非干酪样上皮样细胞肉芽肿，考虑为ICI所致的SLR。
结论
我们报告了首例在接受ICI治疗后因转移性肾细胞癌接受手术且在肾脏病理诊断为SLR的患者。
Zotero 插件