Renal epithelial neoplasms: The diagnostic implications of electron microscopic study in 55 cases
Renal epithelial neoplasms: The diagnostic implications of electron microscopic study in 55 cases
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DOI：
10.1053/hupa.2002.30210
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发表时间：
2002-01-01
期刊：
影响因子：
3.3
通讯作者：
Truong, LD
中科院分区：
文献类型：
--
作者：
Krishnan, B;Truong, LD
肾上皮性肿瘤的组织发生学、疾病分类学和诊断方面的一些尚未确定的因素可能与超微结构有关。然而，一个全面的电子显微镜研究肾上皮肿瘤，根据最近的分类，是不可用的。本文报道了55例肾上皮性肿瘤（透明细胞肾细胞癌31例，乳头状肾细胞癌11例，嫌色细胞肾细胞癌5例，肉瘤样肾细胞癌3例，嗜酸细胞瘤5例）的超微结构与其光镜表现的关系。透明细胞肾细胞癌表现为类似于正常近端小管刷状缘的长微绒毛，胞浆内有丰富的脂质和糖原。乳头状肾细胞癌可见大小不等的微绒毛，胞浆内有少量脂质，但无糖原。嫌色细胞癌细胞胞质内有大量小泡，线粒体异常，少数短而被微绒毛包裹。肾嗜酸细胞瘤细胞质顶端可见较多线粒体和少量小泡，少见短而被微绒毛覆盖。透明细胞肾细胞癌，乳头状肾细胞癌和嫌色细胞肾细胞癌的嗜酸性细胞变体显示出与其各自原型相似的超微结构特征，除了细胞质中线粒体数量增加。1例肉瘤样透明细胞肾细胞癌显示骨骼肌分化。两种类型的细胞质内含物，即透明球和颗粒类似于潘氏细胞（PC样颗粒），仅在透明细胞RCC中被确定，显示出独特的超微结构特征。目前的电镜研究显示了肾上皮肿瘤的独特超微结构特征。这些发现为目前相关肿瘤类型的分类提供了额外的支持，有助于鉴别诊断，并为肾上皮肿瘤可能的组织发生提供了见解。Copyright（C）2002 by W.B.桑德斯公司
Several unsettled histogenetic, nosologic and diagnostic considerations for renal epithelial tumors may have ultrastructural ramifications. Yet, a comprehensive electron microscopic study of renal epithelial neoplasms, in light of the recent classification, is not available. The ultrastructural findings from fifty-five renal epithelial neoplasms [31 clear cell renal cell carcinomas (RCC), 11 papillary RCC, 5 chromophobe RCC, 3 sarcomatoid RCC and 5 oncocytomas] were correlated with their light microscopic appearance. Clear cell RCC showed long microvilli similar to the brush border of the normal proximal tubules, with abundant cytoplasmic lipid and glycogen. Papillary RCC showed variably sized microvilli, and small amounts of cytoplasmic lipid, but no glycogen. Chromophobe RCC showed many cytoplasmic vesicles and abnormal mitochondria, with rare short and stubby microvilli. Renal oncocytoma showed many mitochondria with a few vesicles in the apical portion of the cytoplasm and rare short and stubby microvilli. The eosinophilic cell variants of clear cell RCC, papillary RCC and chromophobe RCC showed ultrastructural features similar to those of their respective prototypes, except for an increased numbers of mitochondria in the cytoplasm. One sarcomatoid clear cell RCC showed skeletal muscle differentiation. Two types of cytoplasmic inclusions, i.e. hyaline globules and granules similar to those in the Paneth cells (PC-like granules) were identified only in clear cell RCC, which displayed distinctive ultrastructural features. The current EM study demonstrates distinctive ultrastructural features of renal epithelial neoplasms. The findings lend additional support to the current classification of the pertinent tumor types, facilitate the differential diagnoses, and provide insights into the possible histogenesis of renal epithelial neoplasms. Copyright (C) 2002 by W.B. Saunders Company.