Spires S E, Banks E R, Cibull M L, Munch L, Delworth M, Alexander N J
Department of Pathology and Laboratory Medicine, University of Kentucky Medical Center, Lexington.
Arch Pathol Lab Med. 1993 Nov;117(11):1156-60.
Adenocarcinoma accounts for a small percentage of neoplasms arising within the renal pelvis. We describe a mucinous adenocarcinoma of the renal pelvis that occurred in a 57-year-old woman. Investigation of the recent literature reveals an additional 12 cases of adenocarcinoma of the renal pelvis reported since 1980. These 13 cases are summarized in detail, for a total of 59 cases of adenocarcinoma of the renal pelvis documented in the English-language literature. These tumors can be subdivided into three major histologic types: tubulovillous, mucinous, and papillary non-intestinal. The tubulovillous and mucinous tumors are morphologically similar to intestinal tumors accounting for 71.5% and 21.5% of cases, respectively. They are believed to arise in foci of intestinal metaplasia. Only three cases (7%) were of the nonintestinal, nonmucinous, papillary subtype. These rare tumors are notable for their morphologic similarity to Bellini or collecting duct carcinoma, but a specific morphologic precursor has not been identified. Of the three subtypes, tumors of tubulovillous morphology confer the worst prognosis with 70% of patients dying within 5 years. Thirty-three percent of mucinous tumors and none of the papillary nonintestinal tumors were fatal.
腺癌在肾盂发生的肿瘤中占比很小。我们描述了一例发生在一名57岁女性身上的肾盂黏液腺癌。对近期文献的调查显示，自1980年以来又有12例肾盂腺癌的报道。这13例病例被详细总结，英文文献中记录的肾盂腺癌病例总数达59例。这些肿瘤可细分为三种主要组织学类型：微管绒毛状、黏液性和乳头状非肠型。微管绒毛状和黏液性肿瘤在形态上与肠型肿瘤相似，分别占病例的71.5%和21.5%。它们被认为起源于肠化生灶。只有3例（7%）为非肠型、非黏液性、乳头状亚型。这些罕见肿瘤因其在形态上与肾乳头管癌或集合管癌相似而引人注目，但尚未确定具体的形态学前驱病变。在这三种亚型中，微管绒毛状形态的肿瘤预后最差，70%的患者在5年内死亡。黏液性肿瘤的死亡率为33%，乳头状非肠型肿瘤无一例致命。
