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目的:探讨肾黏液样小管状和梭形细胞癌(mucinous tubular and spindle cell carcinoma,MTSCC)的临床病理学特征、诊断和鉴别诊断,提高对MTSCC的认识和诊断水平。方法:对2例MTSCC标本进行临床病理分析,并复习相关文献。结果:肿瘤与周围肾组织分界清楚,肿瘤由紧密排列的、小而狭长的小管构成,小管间为淡染的黏液样间质。肿瘤细胞呈立方形和梭形,肿瘤细胞胞质嗜酸性,细胞核圆形或卵圆形,异型性小,核仁不明显,核分裂像少见,在黏液性间质中可见散在淋巴细胞、浆细胞。免疫组织化学显示2例均表达细胞角蛋白(cytokeratin,CK)7,CK18,CK8/18和波形蛋白,Ki-67增殖指数<5%。结论:MTSCC是一种较罕见的低度恶性肿瘤,具有独特的组织学和免疫组织化学特征,明确该肿瘤的形态学特征、诊断和鉴别诊断有重要意义。
Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of mucinous tubular and spindle cell carcinoma (MTSCC) and to improve their understanding and diagnosis of MTSCC. Methods: Two cases of MTSCC specimens were analyzed clinically and pathologically, and relevant literature was reviewed. RESULTS: The delineation of the tumor from the surrounding renal tissue was clear. The tumor was composed of small, narrow, narrow tubules arranged in close proximity to each other and the lightly stained mucoid interstitial space between the tubules. Tumor cells were cuboidal and spindle-shaped, cytoplasm of tumor cells eosinophilic, round or oval nucleus, small atypia, nucleoli are not obvious, mitotic figures rare, visible in the mucinous interstitial scattered lymphocytes, plasma cells . Immunohistochemistry showed cytokeratin (CK) 7, CK18, CK8 / 18 and vimentin were all expressed in 2 cases, proliferation index of Ki-67 was lower than 5%. Conclusions: MTSCC is a relatively rare low-grade malignant tumor with unique histological and immunohistochemical features. It is of great significance to clarify the morphological features, diagnosis and differential diagnosis of this tumor.