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- 肾肿物会诊
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本帖最后由 年华似水 于 2012-09-25 18:45:38 编辑
组织形态学上肿瘤浸润肾实质，实性结构伴腺样及管状分化，异型性显著，纤维性间质反应伴淋巴细胞浸润。差分化癌的诊断可以确立。发生在肾脏的差分化癌鉴别诊断包括：集合管癌（包括髓质癌），浸润性尿路上皮癌，肾细胞癌伴肉瘤样转化，转移性癌。-----广泛取材并借助免疫组化染色，以及临床病理学联系。
1，肿瘤位于肾实质，皮质or髓质？
2，肿瘤与肾盂粘膜的关系。
3，临床病理学联系除外转移。
可参考的最新文献：
1.Kobayashi N, Matsuzaki O, et al.Collecting duct carcinoma of the kidney: an immunohistochemical evaluation of the use of antibodies for differential diagnosis.Hum Pathol. 2008 Sep;39(9):1350-9
2.Albadine R, Schultz L, et al.PAX8 (+)/p63 (-) immunostaining pattern in renal collecting duct carcinoma (CDC): a useful immunoprofile in the differential diagnosis of CDC versus urothelial carcinoma of upper urinary tract.Am J Surg Pathol. 2010 Jul;34(7):965-9.
3.Carvalho JC, Thomas DG et al.p63, CK7, PAX8 and INI-1: an optimal immunohistochemical panel to distinguish poorly differentiated urothelial cell carcinoma from high-grade tumours of the renal collecting system.Histopathology. 2012 Mar;60(4):597-608
4.Young A, Kunju LP.High-grade carcinomas involving the renal sinus: report of a case and review of the differential diagnosis and immunohistochemical expression.Arch Pathol Lab Med. 2012 Aug;136(8):907-10.
5.Gupta R, Billis A et al .Carcinoma of the Collecting Ducts of Bellini and Renal Medullary Carcinoma: Clinicopathologic Analysis of 52 Cases of Rare Aggressive Subtypes of Renal Cell Carcinoma With a Focus on Their Interrelationship.Am J Surg Pathol. 2012 Sep;36(9):1265-1278.
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