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目的探讨原发性肾脏滑膜肉瘤的诊断和治疗。方法对2例患原发性肾脏滑膜肉瘤的患者的临床资料进行总结,检索Pubmed及中国生物医学数据库肾脏原发性滑膜肉瘤的相关文献。结果患者1术后病理报告:肾脏滑膜肉瘤,侵及肾皮质、髓质及肾周围脂肪组织。免疫组化结果:Vim、CK7、广谱CK、低分子CK、EMA、CD99、Bcl-2均阳性,Des阴性。患者2术后病理报告:肾脏滑膜肉瘤,血管内见有瘤栓。免疫组化结果:Vim阳性、CK部分细胞、Des部分细胞、CD99部分细胞阳性,Myod1、CD34、Melanoma、CD68阴性。患者1术后7个月,患者2术后10个月均死于癌转移。检索相关文献显示有随访的33例中死亡11例,转移或复发14例。结论原发性肾脏滑膜肉瘤是一种高度恶性的罕见肿瘤,预后不良,确诊依赖病理检查、免疫组织化学。
Objective To investigate the diagnosis and treatment of primary renal synovial sarcoma. Methods The clinical data of 2 patients with primary renal synovial sarcoma were summarized and the related literature about Pubmed and primary biopsy of kidney in China were searched. Results Patient 1 postoperative pathology report: renal synovial sarcoma, invasion and renal cortex, medulla and perirenal adipose tissue. Immunohistochemical results: Vim, CK7, broad-spectrum CK, low molecular weight CK, EMA, CD99, Bcl-2 were positive, Des negative. Patient 2 postoperative pathology report: renal synovial sarcoma, tumor see thrombus. Immunohistochemical results: Vim positive, CK part of the cells, Des part of the cells, CD99 part of the cells positive, Myod1, CD34, Melanoma, CD68 negative. Patient 1 died 7 months after surgery and patient 2 died of cancer metastasis 10 months after surgery. Retrieval related literature showed that there were 11 cases of death in 33 cases and 14 cases of metastasis or recurrence. Conclusions Primary renal synovial sarcoma is a highly malignant rare tumor with poor prognosis. The diagnosis is based on pathological examination and immunohistochemistry.