Kuromatsu I, Hayashi N, Yanagawa M, Tochigi H, Kawamura J
Department of Urology, Mie University School of Medicine.
Hinyokika Kiyo. 1995 Jan;41(1):47-50.
Primary small cell carcinoma of the renal pelvis is rare. We report a case of combined small cell and transitional cell carcinoma of the renal pelvis. The patient was a 78-year-old man with macrohematuria. He was diagnosed with right pelvic tumor by right retrograde pyelography and computerized tomography. A right radical nephroureterectomy was performed. Histological sections of the tumor showed a mixture of small cell and grade 2 transitional cell carcinoma. Positivity for Grimelius was noted in the small cell component. Masson-Fontana, chromogranin A, serotonin, keratin, leucocyte common antigen (LCA), neuron specific enolase (NSE), adrenocorticotropic hormone (ACTH), growth hormone (GH) and somatostatin were negative. Ultrastructurally, the tumor cells were tightly packed and attached together by scattered desmosomes. There were no neurosecretory granules. Seven months after operation, the patient died with peritonitis carcinomatosa. At autopsy, a metastatic tumor was found in the liver and retroperitoneal lymph node. Other organs were not involved. Especially, there were no abnormalities in the lungs.
肾盂原发性小细胞癌罕见。我们报告一例肾盂小细胞癌与移行细胞癌合并存在的病例。患者为一名78岁男性，有肉眼血尿。经右侧逆行肾盂造影和计算机断层扫描诊断为右侧盆腔肿瘤。行右侧根治性肾输尿管切除术。肿瘤组织切片显示小细胞癌与2级移行细胞癌混合存在。小细胞成分对嗜银染色呈阳性。黑色素染色、嗜铬粒蛋白A、血清素、细胞角蛋白、白细胞共同抗原（LCA）、神经元特异性烯醇化酶（NSE）、促肾上腺皮质激素（ACTH）、生长激素（GH）和生长抑素均为阴性。超微结构上，肿瘤细胞紧密排列，通过散在的桥粒相互连接。未见神经分泌颗粒。术后7个月，患者死于癌性腹膜炎。尸检时，在肝脏和腹膜后淋巴结发现转移性肿瘤。其他器官未受累。特别是肺部无异常。
