Vanatta P R, Silva F G, Taylor W E, Costa J C
Hum Pathol. 1983 Mar;14(3):195-201. doi: 10.1016/s0046-8177(83)80016-1.
A case of renal cell carcinoma associated with systemic amyloidosis in a patient with nephrotic syndrome is presented. Amyloid deposits were present in the resected tumor, ipsilateral kidney, and spleen. Potassium permanganate treatment of histologic sections as well as immunoperoxidase staining identified AA protein within the amyloid. Surgical removal of the tumor caused marked remission of the patient's proteinuria. Thirty-nine previously reported cases of renal cell carcinoma with amyloidosis are reviewed. Most tumors have clear cell histologic features, and the amyloid distribution follows the "secondary" pattern. A possible mechanism of amyloid production in renal cell carcinoma is presented in which the tumor directly or indirectly participates in the modification of SAA protein into a precipitable form.
本文报告了一例肾病综合征患者并发系统性淀粉样变性的肾细胞癌病例。在切除的肿瘤、同侧肾脏和脾脏中均发现有淀粉样沉积物。对组织切片进行高锰酸钾处理以及免疫过氧化物酶染色，在淀粉样物质中鉴定出AA蛋白。手术切除肿瘤后，患者蛋白尿明显缓解。本文还回顾了39例先前报道的伴有淀粉样变性的肾细胞癌病例。大多数肿瘤具有透明细胞组织学特征，淀粉样物质分布呈“继发性”模式。本文提出了肾细胞癌中淀粉样物质产生的一种可能机制，即肿瘤直接或间接参与将血清淀粉样蛋白A（SAA）蛋白修饰成可沉淀形式的过程。
