Raslan W F, Ro J Y, Ordonez N G, Amin M B, Troncoso P, Sella A, Ayala A G
Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston 77030.
Cancer. 1993 Nov 1;72(9):2660-6. doi: 10.1002/1097-0142(19931101)72:9<2660::aid-cncr2820720923>3.0.co;2-o.
Primary carcinoid tumor of the kidney is rare; only 18 patients have been reported. Because of the rarity of the lesion, its prognosis and clinicopathologic features are not well characterized, and its histogenesis is unknown.
Clinicopathologic, immunohistochemical, and ultrastructural studies were performed on five patients with primary carcinoid tumor of the kidney.
Age of the patients ranged from 42 to 63 years, with a mean of 53.2 years. Only one patient had a carcinoid syndrome. Three were men, and two were women. In each patient, the tumor was solitary and confined to the kidney. All tumors had histologic features identical to those of carcinoid tumors affecting other sites. The cytoplasmic granules of the tumor cells were reactive with Grimelius stain in all patients. All tumors also were immunoreactive for keratin, neuron-specific enolase, and chromogranin, but only two patients had tumors that reacted for serotonin, pancreatic polypeptide, and vasoactive intestinal polypeptide. Ultrastructural studies showed numerous intracytoplasmic neuroendocrine granules in four tumors. One patient had Robson Stage I cancer, and two each had Stage II and IV cancer. The two patients with Stage IV tumor died of disease at 36 months and 28 months after diagnosis; one patient with Stage II carcinoid is alive without clinical evidence of residual disease 8 years after control of metastases; the other patient with Stage II and the patient with Stage I cancer are alive and well without evidence of disease at 36 months, and 2 months, respectively.
Tumor stage at presentation appears to be the most important factor in determining outcome. The number of mitoses and degree of cellular atypia appear to be important pathologic parameters in predicting prognosis, despite the limited number of patients reported in this report.
原发性肾类癌罕见，仅报道过18例患者。由于该病变罕见，其预后和临床病理特征尚未得到充分描述，组织发生也尚不清楚。
对5例原发性肾类癌患者进行了临床病理、免疫组化和超微结构研究。
患者年龄在42至63岁之间，平均年龄为53.2岁。只有1例患者有类癌综合征。3例为男性，2例为女性。每位患者的肿瘤均为单发且局限于肾脏。所有肿瘤的组织学特征均与影响其他部位的类癌相同。所有患者肿瘤细胞的胞质颗粒对嗜银染色呈阳性反应。所有肿瘤对角蛋白、神经元特异性烯醇化酶和嗜铬粒蛋白也呈免疫反应，但只有2例患者的肿瘤对血清素、胰多肽和血管活性肠多肽呈反应。超微结构研究显示，4例肿瘤中有大量胞质内神经内分泌颗粒。1例患者为罗布森I期癌，2例为II期癌，2例为IV期癌。2例IV期肿瘤患者分别在诊断后36个月和28个月死于该病；1例II期类癌患者在转移得到控制8年后存活，无残留疾病的临床证据；另1例II期患者和I期癌患者分别在36个月和2个月时存活且情况良好，无疾病证据。
就诊时的肿瘤分期似乎是决定预后的最重要因素。尽管本报告中报道的患者数量有限，但有丝分裂数和细胞异型程度似乎是预测预后的重要病理参数。
