Davis C J, Barton J H, Sesterhenn I A, Mostofi F K
Department of Genitourinary Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000, USA.
Am J Surg Pathol. 1995 Oct;19(10):1101-14. doi: 10.1097/00000478-199510000-00001.
We report 50 examples of an uncommon type of renal adenoma from the files of the Armed Forces Institute of Pathology. They appear to be benign tumors with no malignant potential, and their chief importance is related to the fact that they are most often misinterpreted as renal cell carcinoma or epithelial Wilms' tumor. They predominated in females by well over 2:1. The mean age of the patients was 41 years, with a range of 5 to 83 years, and the mean size was 5.5 cm, with a range of 0.3 to 15.0 cm. Presenting signs and symptoms included pain in 11, hematuria in five, and palpable mass in five. In 20 patients the tumors were found incidentally during evaluation for other problems, and in six the other problem was polycythemia. This finding establishes a higher incidence of polycythemia in renal adenoma than in other previously reported renal diseases. Also of preoperative importance is the fact that these tumors are more commonly calcified than other renal neoplasms. Microscopically, these tumors consist of very small epithelial cells that form very small acini in an acellular stroma. Less often, they form tubular, glomeruloid, or polypoid and papillary formations. Most also show evidence of regression in the form of scarring and calcification. These lesions seem histogenetically related to epithelial Wilms' tumor, and, in fact, the two may occur together. They are histologically very similar to the metanephric hamartomatous element of nephroblastomatosis.
我们从武装部队病理研究所的档案中报告了50例罕见类型的肾腺瘤。它们似乎是良性肿瘤，没有恶变潜能，其主要重要性在于它们最常被误诊为肾细胞癌或上皮性威尔姆斯瘤。女性患者明显占优，比例超过2比1。患者的平均年龄为41岁，范围在5至83岁之间，平均大小为5.5厘米，范围在0.3至15.0厘米之间。出现的体征和症状包括11例疼痛、5例血尿和5例可触及肿块。20例患者在因其他问题进行评估时偶然发现肿瘤，6例患者的其他问题是红细胞增多症。这一发现表明肾腺瘤中红细胞增多症的发生率高于其他先前报道的肾脏疾病。术前同样重要的是，这些肿瘤比其他肾肿瘤更常发生钙化。显微镜下，这些肿瘤由非常小的上皮细胞组成，这些细胞在无细胞基质中形成非常小的腺泡。较少见的情况下，它们会形成管状、肾小球样、息肉样或乳头状结构。大多数肿瘤还表现出以瘢痕形成和钙化为形式的退变迹象。这些病变在组织发生学上似乎与上皮性威尔姆斯瘤相关，事实上，两者可能同时出现。它们在组织学上与肾母细胞瘤病的后肾错构瘤成分非常相似。
