Antimitochondrial antibody (113-1) in the differential diagnosis of granular renal cell tumors
Antimitochondrial antibody (113-1) in the differential diagnosis of granular renal cell tumors
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DOI：
10.1097/00000478-199708000-00006
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发表时间：
1997-08-01
影响因子：
5.6
通讯作者：
Zarbo, RJ
中科院分区：
文献类型：
--
作者：
Tickoo, SK;Amin, MB;Zarbo, RJ
大量的颗粒状嗜酸性细胞质是肾嗜酸细胞瘤、嫌色细胞肾细胞癌、乳头状肾细胞癌的嗜酸性变体和透明细胞肾细胞癌（RCC）的颗粒变体的共同特征。这些实体中的每一个都具有独特的结构模式和独特的分子或细胞遗传学特征。它们彼此区别的主要原因是它们生物学行为的差异。仔细和彻底的光学显微镜检查区分大多数情况下，根据个人特点的建筑和细胞形态学特征。然而，在某些情况下，由于重叠的形态特征，精确表征可能是困难的。我们评估了抗线粒体抗体113-1，试图确定57例颗粒状肾肿瘤的免疫染色模式的差异，包括20例肾嗜酸细胞瘤，15例嫌色细胞RCC，13例透明细胞RCC的颗粒变体，9例乳头状RCC的嗜酸性变体。各组间观察到独特且几乎排他性的染色模式，嫌色细胞RCC显示粗细胞质颗粒的外周加重（15/15），肾嗜酸细胞瘤具有弥漫性和细颗粒（20/20），透明细胞RCC的颗粒变体具有粗颗粒的不规则细胞质分布（11/13）。染色在乳头状肾细胞癌的嗜酸性变体中最强烈，通常呈粗颗粒状和弥漫性。在嫌色细胞肾细胞癌和透明细胞肾细胞癌的颗粒变体中，透明细胞区域的染色模式也不同。虽然透明细胞在前一组中显示颗粒染色，周边加重，在后者中的大多数透明细胞缺乏任何染色。我们的结论是，除了独特的细胞结构特征，抗线粒体抗体113-1的免疫染色模式似乎是一个有用的鉴别辅助复杂的鉴别诊断肾颗粒细胞瘤。
Abundant granular eosinophilic cytoplasm is a common feature of renal oncocytoma, chromophobe renal cell carcinoma, eosinophilic variant of papillary renal cell carcinoma, and the granular variant of clear cell renal cell carcinoma (RCC). Each of these entities has a unique architectural pattern and a distinctive molecular or cytogenetic profile. The chief reason for their distinction from one another is the difference in their biologic behavior. Careful and thorough light microscopic examination distinguishes most cases based on individual characteristic architectural and cytomorphologic features. However, precise characterization may be difficult in some cases because of overlapping morphologic features. We evaluated the antimitochondrial antibody 113-1 in an attempt to ascertain differences in immunostaining patterns in 57 cases of granular renal tumors, including 20 renal oncocytomas, 15 chromophobe RCCs, 13 granular variants of clear cell RCC, and nine eosinophilic variants of papillary RCC. Distinctive, and nearly exclusive, staining patterns were observed among the groups, with chromophobe RCC showing peripheral accentuation of coarse cytoplasmic granules (15 of 15), renal oncocytoma with diffuse and fine granularity (20 of 20), and granular variant of clear cell RCC with irregular cytoplasmic distribution of coarse granules (11 of 13). Staining was most intense in the eosinophilic variant of papillary RCC and was generally coarsely granular and diffuse. Staining patterns also differed in clear cell areas within chromophobe RCC and the granular variant of clear cell RCC. Although clear cells in the former group showed granular staining with peripheral accentuation, most of the clear cells in the latter lacked any staining. We conclude that, in addition to distinct cytoarchitectural features, immunostaining patterns with antimitochondrial antibody 113-1 appear to be a useful discriminatory adjunct in the complex differential diagnosis of granular renal cell tumors.