目的：探讨肾素瘤的组织病理学特点，做到正确诊断。方法：对肿瘤进行临床和组织病理学、免疫组织化学和超微结构观察。结果：临床表现为重症肾素性高血压伴发严重心衰。镜下瘤细胞生长活跃，核异型性，核分裂像易见，瘤组织灶性变性坏死，浸润包膜。超微结构观察瘤细胞胞质内可见散在或群集的圆形、菱形分泌颗粒。结论：肾素瘤是一种内分泌肿瘤，一般认为来源于肾小球球旁细胞，本例免疫组化提示与血管内皮及神经内分泌有关，外科手术切除后高血压症状得到缓解，愈后好。正确诊断需要光镜、免疫组化与电镜观察相结合。
Objective: To elucidate the morphologic features and diagnostic evidence of reninoma of kidney. Methods: The clinic features of the patient were reviewed and the histopathological and ultra-structural features were observed by immunohistochemistry, light and electron microscopes. Re-sults: The patient showed severe renal hypertention and severe heart failure. Under light micro-scope, the tumor showed active proliferation, remarkable heterokaryosis with hyperchromatic, irregular outline and pleomorphic nuclear and more mitosis. The tumor cells showed invasive growth and massive necrosis. Under electron microscope, many dispersed and multitudinous round or diamond granules were seen in the cytoplasm of the tumor cells. Conclusion: The tumor is a kind of endocrine tumor and is considered to be juxtaglomerular call origin. The immunohistochemical results of the reported case suggest that the tumor origin is associated with neuroendocrine and endothelium of vascular. The hypertention-related symptoms disappear after operation and the prognosis of the patient is well. The correct diagnosis needs to unite the light and electron microscopes observation.
