摘要目的：探讨不同组织类型嗜酸细胞性肾肿瘤的形态学特点及免疫表型特征，为该类肿瘤的鉴别诊断提供参考依据。方法收集75例具有嗜酸细胞形态的肾肿瘤，应用光镜观察组织学形态，采用组织芯片技术进行免疫组织化学染色。结果不同组织类型的嗜酸性肾肿瘤形态学上有一定重叠，但各有其独特的病理学特点。免疫组织化学染色：嗜酸细胞瘤与嗜酸型嫌色细胞癌除了CK7表达不同，其他免疫表型非常相似，CK7在两者中的阳性表达比例分别为2／19和17／20。嗜酸型透明细胞肾细胞癌：波形蛋白及碳酸酐酶Ⅸ（ CAⅨ）阳性，CK7和CD117阴性是该肿瘤的主要免疫表型（10／15）。嗜酸型乳头状肾癌：13例中有10例强阳性表达α-甲酰辅酶A消旋酶（AMACR），波形蛋白、CK7和CD10不同程度表达，阳性比例分别为8／13、9／13和6／13，而CAⅨ、CD117和TFE3均阴性；上皮样血管平滑肌脂肪瘤：波形蛋白、平滑肌肌动蛋白和HMB45阳性，而CAⅨ和CK7均阴性；XP11.2易位性肾细胞癌：癌细胞强阳性表达波形蛋白、CD10、AMACR和TFE3，CK7、CD117和HMB45多数不表达。结论充分认识嗜酸细胞性肾肿瘤的形态特点，并应用波形蛋白、CAⅨ、CK7、CD10、AMACR、CD117、TFE3和HMB45对该类肿瘤的鉴别诊断具有重要的作用。

abstractsObjective To investigate the morphological features and immunophenotypes of eosinophilic renal tumors in order to provide references for the differential diagnosis of this tumor.Methods A cohort of 75 cases of eosinophilic renal tumors were collected.The morphological features of the tumors were observed under microscope, and the immunophenotypes of the tumors were detected using tissue microarray and immunoshistochemistry.Results There were some overlaps between the different types of eosinophilic renal tumors in morphology, but each had its distinct characteristics.Immunohistochemically, renal oncocytoma ( RO) and eosinophilic chromophobe renal cell carcinoma ( ChRCC) shared some common immumophenotypes, except for the expression of CK7, with the expression rates of 2/19 in RO and 17/20 in eosinophilic ChRCC, respectively.Eosinophilic clear cell renal cell carcinoma mainly showed positive immunostaining for Vimentin and CAⅨ, whereas negative for CK7 and CD117 in most cases ( 10/15 ).AMACR was diffusely expressed in the majority of eosinophilic papillary renal cell carcinoma ( PRCC, 10/13).Furthermore, vimentin, CK7 and CD10 were positively expressed in eosinophilic PRCC with the expression rates of 8/13, 9/13 and 6/13, respectively;while CAⅨ, CD117 and TFE3 were all negatively expressed in eosinophilic PRCC.Epithelioid angiomyolipoma generally showed positive expression of vimentin,SMA and HMB45, but negative expression of CAⅨ and CK7.Vimentin, CD10, AMACR and TFE3 were strongly expressed in XP11.2 translocation renal cell carcinoma;on the contrary, CK7, CD117and HMB45 were not expressed in the majority of the tumor.Conclusion With full understanding of the morphology of different types of eosinophilic renal tumors, the immunostaining of vimentin, CAⅨ, CK7, CD10, AMACR, CD117, TFE3 and HMB45 could play a crucial role in the differential diagnosis of these tumors.