巨大肾原发性鳞状细胞癌的组织起源及临床病理学观察

A Clinicopathological Observation and Histogenesis of Huge Primary Renal Squamous Cell Carcinoma

摘要: 巨大肾原发性鳞状细胞癌在临床上少见，其组织学起源尚存争议。本例患者女性，67岁，因左腰部疼痛伴肉眼血尿5个月入院。患者行左肾切除术。肾肿瘤巨大，占据整个肾脏。肿瘤细胞由典型的鳞状细胞癌组成，具有侵袭性生长伴有坏死。肾盂黏膜可见移形上皮向鳞状上皮化生、不典型增生到癌变的过程。免疫组化标记癌细胞表达CEA、34βE12、CK5/6、CK7、CK8、CK14阳性，Ki-67阳性高表达，而不表达Vimentin、S-100蛋白。研究结果支持肿瘤起源于肾盂黏膜的鳞状上皮化生。

Abstract: Huge primary renal squamous cell carcinoma was rare in clinic, and its origin of histology is con-troversial. In this case, a 67-year-old woman was admitted to hospital with a history of left lumbage and gross hematuria for five months. The patient was performed left nephrectomy. The renal tumor was huge and occupied by the entire kidney. Microscopically, the tuomr was composed of typical squamous cell carcinoma with invasive growth and necrosis. The mucosa of renal pelvis was found with squamous metaplasia, atypical hyperplasia and canceration. Immunohistochemically, tumor cells showed strong immunoreactivity for CEA, 34βE12, CK5/6, CK7, CK8, CK14, Ki-67, and negative for Vimentin, S-100 protein. These results support that the tumor was originated from squamous metaplasia of renal pelvic mucosa.