Acquired cystic disease-associated renal cell carcinoma: further characterization of the morphologic and immunopathologic features
Acquired cystic disease-associated renal cell carcinoma: further characterization of the morphologic and immunopathologic features
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DOI：
10.1007/s00795-013-0028-x
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发表时间：
2013-12-01
影响因子：
1.8
通讯作者：
Shim, Jung Won
中科院分区：
文献类型：
--
作者：
Ahn, Soomin;Kwon, Ghee Young;Shim, Jung Won
获得性囊性疾病相关性肾细胞癌（Acquired cystic disease associated renal cell carcinoma，ACD-RCC）是肾细胞癌（renal cell carcinoma，RCC）的一种亚型，具有独特的形态学特征，仅见于终末期肾病背景。我们分析了12例ACD-RCC的临床病理特征和免疫反应谱，以进一步描述这种最近被认识的实体。结合针对当代诊断抗体和假定的靶向治疗相关标志物的免疫组织化学染色，对组织学切片进行审查。组织学上，肿瘤表现出特征性的内部或细胞内微腔和嗜酸性肿瘤细胞。瘤内含铁血黄素沉积和退化的泡沫状肿瘤细胞是以前没有描述过的一致结果。免疫组化显示，所有肿瘤均为α-甲酰基-CoA-消旋酶、CD 10、泛细胞角蛋白、PTEN（10号染色体上缺失的磷酸酶和张力蛋白同源物）和c-met阳性，而碳酸酐酶-9、CD 57、CD 68、c-kit、pax-2、血小板衍生生长因子受体（PDGFR）-α或血管内皮生长因子受体（VEGFR）-2阴性。CK 7和肾特异性钙粘蛋白染色不均匀。对c-met的阳性反应表明其可作为ACD-RCC的合理治疗靶点。因此，我们提出ACD-RCC独特的形态学和免疫病理学特征，这可能有助于诊断和治疗方面。
Acquired cystic disease-associated renal cell carcinoma (ACD-RCC) is a subtype of renal cell carcinoma (RCC) with unique morphologic features found exclusively in the background of end-stage renal disease. We analyzed the clinicopathologic features and immumoreactive profiles of 12 cases of ACD-RCC to further characterize this recently recognized entity. Review of histologic slides was performed in conjunction with immunohistochemical staining directed to the contemporary diagnostic antibodies and the putative target therapy-related markers. Histologically, the tumors showed characteristic inter-or intracellular microlumens and eosinophilic tumor cells. Intratumoral hemosiderin deposition and degenerating foamy tumor cells were consistent findings which were not previously described. Immunohistochemically, all the tumors were positive for alpha-methylacyl-CoA-racemase, CD10, pan-cytokeratin, PTEN (phosphatase and tensin homolog deleted on chromosome 10) and c-met, while negative for carbonic anhydrase-9, CD57, CD68, c-kit, pax-2, platelet-derived growth factor receptor (PDGFR)-alpha or vascular endothelial growth factor receptor (VEGFR)-2. Heterogenous staining was found for CK7 and kidney-specific cadherin. Positive reaction to c-met suggests its utility as a plausible therapeutic target in ACD-RCC. Thus, we present the unique morphologic and immunopathologic features of ACD-RCC, which may be helpful in both diagnostic and therapeutic aspects.