The Morphologic and Immunohistochemical Spectrum of Papillary Renal Cell Carcinoma Study Including 132 Cases With Pure Type 1 and Type 2 Morphology As Well As Tumors With Overlapping Features
The Morphologic and Immunohistochemical Spectrum of Papillary Renal Cell Carcinoma Study Including 132 Cases With Pure Type 1 and Type 2 Morphology As Well As Tumors With Overlapping Features
复制标题
DOI：
10.1097/pas.0000000000000247
复制
发表时间：
2014-07-01
影响因子：
5.6
通讯作者：
Brimo, Fadi
中科院分区：
文献类型：
--
作者：
Chevarie-Davis, Myriam;Riazalhosseini, Yasser;Brimo, Fadi
乳头状肾细胞癌（pRCC）通常分为1型和2型肿瘤。然而，许多情况并不满足这两种类型的所有标准。我们描述了132例prcc的临床、形态学和免疫组织化学（IHC）特征，以更好地表征具有重叠特征的肿瘤的频率和性质。对病例进行审查和分类；对95例患者进行了免疫组化评价CK7、EMA、TopoII α、napsin A和AMACR。1型、2型和“重叠型”pRCC的发生率分别为25%、28%和47%。两类“重叠”肿瘤为：(1)有淡色立方细胞，但无嗜碱性细胞质（A型）；(2)主要为1型组织学，并伴有核仁突出的区域（B型）。“重叠”病例的病理分期与1型肿瘤一致。使用两种区分标记（CK7， EMA），“A型”病例与1型相似。尽管“B型”肿瘤的高核分级区与低核分级区在染色上有所不同，但它们的免疫组化谱更接近1型。单核苷酸多态性阵列结果，虽然是初步的，仅限于9例（3例有重叠特征），似乎也证实了这些发现。总之，我们证明，在肿瘤中，细胞质质量的变化和/或高级别核的存在，在其他方面表现出1型prcc的特征，在分期和IHC谱上与典型的1型组织学相似，这表明它们的谱可能比最初描述的更宽。
Papillary renal cell carcinomas (pRCC) are classically divided into type 1 and 2 tumors. However, many cases do not fulfill all the criteria for either type. We describe the clinical, morphologic, and immunohistochemical (IHC) features of 132 pRCCs to better characterize the frequency and nature of tumors with overlapping features. Cases were reviewed and classified; IHC evaluation of CK7, EMA, TopoII alpha, napsin A, and AMACR was performed on 95 cases. The frequencies of type 1, type 2, and "overlapping" pRCC were 25%, 28%, and 47%, respectively. The 2 categories of "overlapping" tumors were: (1) cases with bland cuboidal cells but no basophilic cytoplasm (type A); and (2) cases with predominantly type 1 histology admixed with areas showing prominent nucleoli (type B). The pathologic stage of "overlapping" cases showed concordance with type 1 tumors. Using the 2 discriminatory markers (CK7, EMA), "type A" cases were similar to type 1. Although the high-nuclear grade areas of "type B" tumors showed some staining differences from their low-nuclear grade counterpart, their IHC profile was closer to type 1. Single nucleotide polymorphism array results, although preliminary and restricted to only 9 cases (3 with overlapping features), also seemed to confirm those findings. In conclusion, we demonstrate that variations in cytoplasmic quality and/or presence of high-grade nuclei in tumors otherwise displaying features of type 1 pRCCs are similar in stage and IHC profile those with classic type 1 histology, suggesting that their spectrum might be wider than originally described.