肾球旁细胞瘤的临床病理观察_West China Medical Journal

Authors：

 苏征征 , 陈铌 , 龚静 , 聂玲 , 陈雪芹 ,  周桥

四川大学华西医院病理科成都 610041;

Corresponding author：

周桥, Email: zhou_qiao@hotmail.com

Keywords：

肾球旁细胞瘤; 电子显微镜; 免疫组织化学

DOI：

10.7507/1002-0179.20150598

Video：

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目的探讨肾球旁细胞瘤的临床病理特征、诊断与鉴别诊断。方法对于2012年11月21日就诊的1例肾球旁细胞瘤的临床表现、病理改变和超微结构改变进行观察分析并作文献复习。结果患者临床表现为高血压、高肾素血症、高醛固酮血症和低血钾。左肾实质内见一巨大肿瘤，行左肾切除术。光学显微镜下见形态一致的多边形或圆形肿瘤细胞呈片状、巢团状或围血管生长，可见血管外皮瘤样构像；免疫组织化学呈CD34弥漫阳性，平滑肌肌动蛋白局灶阳性，广谱细胞角蛋白、上皮细胞膜抗原、S-100、人黑色素瘤特异性抗体、嗜铬素A、突触素均阴性；透射电子显微镜下可见特征性菱形晶体（前肾素颗粒），确诊为肾球旁细胞瘤。结论肾球旁细胞瘤是少见的肾脏肿瘤，易误诊为其他肿瘤，知晓该病并熟悉其组织病理学和超微结构特征是正确诊断的关键。

Citation： 苏征征, 陈铌, 龚静, 聂玲, 陈雪芹, 周桥. 肾球旁细胞瘤的临床病理观察. West China Medical Journal, 2015, 30(11): 2115-2117. doi: 10.7507/1002-0179.20150598 Copy

1.	Robertson PW, Klidjian A, Harding LK, et al. Hypertension due to a renin-secreting renal tumour[J]. Am J Med, 1967, 43(6):963-976.
2.	Prejbisz A, Antoniewicz AA, Kabat M, et al. Renin-secreting juxtaglomerular cell tumor of the kidney causing severe hypertension and polyuria[J]. Pol Arch Med Wewn, 2014, 124(4):207-208.
3.	John NE, Guido S, Jonathan E, et al. World Health Organization Classification of tumours:pathology & genetics of tumours of the urinary system and male genital organs[M]. Elsevier, 2004.
4.	Dong D, Li H, Yan W, et al. Juxtaglomerular cell tumor of the kidney:-a new classification scheme[J]. Urol Oncol, 2010, 28(1):34-38.
5.	Endoh Y, Motoyama T, Hayami S, et al. Juxtaglomerular cell tumor of the kidney:report of a non-functioning variant[J]. Pathol Int, 1997, 47(6):393-396.
6.	Squires JP, Ulbright TM, DeSchryver-Kecskemeti K, et al. Juxtaglomerular cell tumor of the kidney[J]. Cancer, 1984, 53(3):516-523.
7.	Kuroda N, Maris S, Monzon FA, et al. Juxtaglomerular cell tumor:a morphological, immunohistochemical and genetic study of six cases[J]. Hum Pathol, 2013, 44(1):47-54.
8.	Duan X, Bruneval P, Hammadeh R, et al. Metastatic juxtaglomerular cell tumor in a 52-year-old man[J]. Am J Surg Pathol, 2004, 28(8):1098-1102.
9.	Têtu B, Vaillancourt L, Camilleri JP, et al. Juxtaglomerular cell tumor of the kidney:report of two cases with a papillary pattern[J]. Hum Pathol, 1993, 24(11):1168-1174.
10.	Lachvac L, Svajdler M, Valansky L, et al. Juxtaglomerular cell tumor, causing fetal demise[J]. Int Urol Nephrol, 2011, 43(2):365-370.
11.	Martin SA, Mynderse LA, Lager DJ, et al. Juxtaglomerular cell tumor:a clinicopathologic study of four cases and review of the literature[J]. Am J Clin Pathol, 2001, 116(6):854-863.
12.	游燕, 梁智勇, 朱翀, 等. 肾球旁细胞瘤2例临床病理探讨[J]. 诊断病理学杂志, 2012, 19(4):259-262.
13.	Kim HJ, Kim CH, Choi YJ, et al. Juxtaglomerular cell tumor of kidney with CD34 and CD117 immunoreactivity:report of 5 cases[J]. Arch Pathol Lab Med, 2006, 130(5):707-711.
14.	Shao L, Manalang M, Cooley L. Juxtaglomerular cell tumor in an 8-year-old girl[J]. Pediatr Blood Cancer, 2008, 50(2):406-409.
15.	Capovilla M, Couturier J, Molinié V, et al. Loss of chromosomes 9 and 11 May be recurrent chromosome imbalances in juxtaglomerular cell tumors[J]. Hum Pathol, 2008, 39(3):459-462.
16.	Brandal P, Busund LT, Heim S. Chromosome abnormalities in juxtaglomerular cell tumors[J]. Cancer, 2005, 104(3):504-510.
17.	Steffens J, Bock R, Braedel HU, et al. Renin-producing renal cell carcinoma[J]. Eur Urol, 1990, 18(1):56-60.
18.	Lindop GB, Fleming S. Renin in renal cell carcinoma——an immunocytochemical study using an antibody to pure human renin[J]. J Clin Pathol, 1984, 37(1):27-31.
19.	Hasegawa T, Matsuno Y, Shimoda T, et al. Extrathoracic solitary fibrous tumors:their histological variability and potentially aggressive behavior[J]. Hum Pathol, 1999, 30(12):1464-1473.
20.	Kuroda N. Editorial comment from Dr Kuroda to Glomus tumor of the kidney[J]. Int J Urol, 2011, 18(12):871.
21.	Gherardi GJ, Arya S, Hickler RB. Juxtaglomerular body tumor:a rare occult but curable cause of lethal hypertension[J]. Hum Pathol, 1974, 5(2):236-240.
22.	Kodet R, Taylor M, Váchalová H, et al. Juxtaglomerular cell tumor. An immunohistochemical, electron-microscopic, and in situ hybridization study[J]. Am J Surg Pathol, 1994, 18(8):837-842.
23.	Beaudoin J, Périgny M, Têtu B, et al. A patient with a juxtaglomerular cell tumor with histological vascular invasion[J]. Nat Clin Pract Nephrol, 2008, 4(8):458-462.
24.	Shera AH, Baba AA, Bakshi IH, et al. Recurrent malignant juxtaglomerular cell tumor:a rare cause of malignant hypertension in a child[J]. J Indian Assoc Pediatr Surg, 2011, 16(4):152-154.

1. Robertson PW, Klidjian A, Harding LK, et al. Hypertension due to a renin-secreting renal tumour[J]. Am J Med, 1967, 43(6):963-976.
2. Prejbisz A, Antoniewicz AA, Kabat M, et al. Renin-secreting juxtaglomerular cell tumor of the kidney causing severe hypertension and polyuria[J]. Pol Arch Med Wewn, 2014, 124(4):207-208.
3. John NE, Guido S, Jonathan E, et al. World Health Organization Classification of tumours:pathology & genetics of tumours of the urinary system and male genital organs[M]. Elsevier, 2004.
4. Dong D, Li H, Yan W, et al. Juxtaglomerular cell tumor of the kidney:-a new classification scheme[J]. Urol Oncol, 2010, 28(1):34-38.
5. Endoh Y, Motoyama T, Hayami S, et al. Juxtaglomerular cell tumor of the kidney:report of a non-functioning variant[J]. Pathol Int, 1997, 47(6):393-396.
6. Squires JP, Ulbright TM, DeSchryver-Kecskemeti K, et al. Juxtaglomerular cell tumor of the kidney[J]. Cancer, 1984, 53(3):516-523.
7. Kuroda N, Maris S, Monzon FA, et al. Juxtaglomerular cell tumor:a morphological, immunohistochemical and genetic study of six cases[J]. Hum Pathol, 2013, 44(1):47-54.
8. Duan X, Bruneval P, Hammadeh R, et al. Metastatic juxtaglomerular cell tumor in a 52-year-old man[J]. Am J Surg Pathol, 2004, 28(8):1098-1102.
9. Têtu B, Vaillancourt L, Camilleri JP, et al. Juxtaglomerular cell tumor of the kidney:report of two cases with a papillary pattern[J]. Hum Pathol, 1993, 24(11):1168-1174.
10. Lachvac L, Svajdler M, Valansky L, et al. Juxtaglomerular cell tumor, causing fetal demise[J]. Int Urol Nephrol, 2011, 43(2):365-370.
11. Martin SA, Mynderse LA, Lager DJ, et al. Juxtaglomerular cell tumor:a clinicopathologic study of four cases and review of the literature[J]. Am J Clin Pathol, 2001, 116(6):854-863.
12. 游燕, 梁智勇, 朱翀, 等. 肾球旁细胞瘤2例临床病理探讨[J]. 诊断病理学杂志, 2012, 19(4):259-262.
13. Kim HJ, Kim CH, Choi YJ, et al. Juxtaglomerular cell tumor of kidney with CD34 and CD117 immunoreactivity:report of 5 cases[J]. Arch Pathol Lab Med, 2006, 130(5):707-711.
14. Shao L, Manalang M, Cooley L. Juxtaglomerular cell tumor in an 8-year-old girl[J]. Pediatr Blood Cancer, 2008, 50(2):406-409.
15. Capovilla M, Couturier J, Molinié V, et al. Loss of chromosomes 9 and 11 May be recurrent chromosome imbalances in juxtaglomerular cell tumors[J]. Hum Pathol, 2008, 39(3):459-462.
16. Brandal P, Busund LT, Heim S. Chromosome abnormalities in juxtaglomerular cell tumors[J]. Cancer, 2005, 104(3):504-510.
17. Steffens J, Bock R, Braedel HU, et al. Renin-producing renal cell carcinoma[J]. Eur Urol, 1990, 18(1):56-60.
18. Lindop GB, Fleming S. Renin in renal cell carcinoma——an immunocytochemical study using an antibody to pure human renin[J]. J Clin Pathol, 1984, 37(1):27-31.
19. Hasegawa T, Matsuno Y, Shimoda T, et al. Extrathoracic solitary fibrous tumors:their histological variability and potentially aggressive behavior[J]. Hum Pathol, 1999, 30(12):1464-1473.
20. Kuroda N. Editorial comment from Dr Kuroda to Glomus tumor of the kidney[J]. Int J Urol, 2011, 18(12):871.
21. Gherardi GJ, Arya S, Hickler RB. Juxtaglomerular body tumor:a rare occult but curable cause of lethal hypertension[J]. Hum Pathol, 1974, 5(2):236-240.
22. Kodet R, Taylor M, Váchalová H, et al. Juxtaglomerular cell tumor. An immunohistochemical, electron-microscopic, and in situ hybridization study[J]. Am J Surg Pathol, 1994, 18(8):837-842.
23. Beaudoin J, Périgny M, Têtu B, et al. A patient with a juxtaglomerular cell tumor with histological vascular invasion[J]. Nat Clin Pract Nephrol, 2008, 4(8):458-462.
24. Shera AH, Baba AA, Bakshi IH, et al. Recurrent malignant juxtaglomerular cell tumor:a rare cause of malignant hypertension in a child[J]. J Indian Assoc Pediatr Surg, 2011, 16(4):152-154.

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肾球旁细胞瘤的临床病理观察

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