Grignon D J, Eble J N
Department of Pathology, Wayne State University, Detroit, MI, USA.
Semin Diagn Pathol. 1998 Feb;15(1):41-53.
Papillary renal adenomas are the commonest neoplasms of the renal tubular epithelium, occurring in up to 40% of adults. If these criteria are met, the diagnosis of adenoma can be made with confidence: (1) papillary, tubular, or tubulopapillary architecture; (2) diameter less than or equal to 5 mm; and (3) does not histologically resemble clear cell, chromophobe, or collecting duct renal cell carcinomas. They are composed of epithelial cells with variable amounts of cytoplasm with variable tinctorial qualities including clear. Metanephric adenoma and metanephric adenofibroma are closely related neoplasms that appear to be benign. Although they have a morphological resemblance to Wilms' tumor, there is some genetic evidence relating them to papillary adenoma and papillary renal cell carcinoma. Metanephric adenoma and metanephric adenofibroma occur at all ages, have a 2:1 predominance of female patients, and are associated with polycythemia. No instance of malignant behavior has been reported. The adenomatous component is composed of uniform small cells arranged in tubular or papillary architectural patterns. The fibromatous component is moderately cellular and composed of bland spindle cells.
乳头状肾腺瘤是肾小管上皮最常见的肿瘤，在高达40%的成年人中出现。如果符合以下标准，即可确诊为腺瘤：（1）乳头状、管状或小管乳头状结构；（2）直径小于或等于5毫米；（3）组织学上与透明细胞、嫌色细胞或集合管肾细胞癌不同。它们由上皮细胞组成，细胞质数量可变，染色特性各异，包括透明。后肾腺瘤和后肾腺纤维瘤是密切相关的肿瘤，似乎是良性的。尽管它们在形态上与肾母细胞瘤相似，但有一些遗传学证据将它们与乳头状腺瘤和乳头状肾细胞癌联系起来。后肾腺瘤和后肾腺纤维瘤可发生于各年龄段，女性患者占比为2:1，且与红细胞增多症有关。尚未有恶性行为的报道。腺瘤成分由排列成管状或乳头状结构模式的均匀小细胞组成。纤维瘤成分细胞中度密集，由温和的梭形细胞组成。
