Adult Papillary Renal Tumor With Oncocytic Cells: Clinicopathologic, Immunohistochemical, and Cytogenetic Features of 10 Cases
Adult Papillary Renal Tumor With Oncocytic Cells: Clinicopathologic, Immunohistochemical, and Cytogenetic Features of 10 Cases
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DOI：
10.1097/01.pas.0000184821.09871.ec
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发表时间：
2005-12
期刊：
影响因子：
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通讯作者：
M. Lefevre;J. Couturier;M. Sibony;C. Bazille;K. Boyer;P. Callard;A. Vieillefond;Y. Allory
中科院分区：
文献类型：
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作者：
M. Lefevre;J. Couturier;M. Sibony;C. Bazille;K. Boyer;P. Callard;A. Vieillefond;Y. Allory
我们报告10例嗜酸细胞性肾乳头状肿瘤，目的是确定其临床病理特征。所有患者均为男性（中位年龄71岁），均行根治性肾切除术，无复发或转移（中位随访时间62个月）。肿瘤（中位尺寸，3.3 cm）位于肾内，局限性良好，无肾外扩展。它们由薄的非纤维化乳头组成，内衬单层嗜酸性细胞，具有细颗粒状嗜酸性细胞质和圆形规则核，显示中央核仁（Fuhrman II级，除一个III级外）。大多数病例存在坏死灶。所有肿瘤均为α-甲酰基辅酶A消旋酶、波形蛋白和CD 10免疫反应阳性; 4例表达肾细胞癌抗原，3例表达细胞角蛋白7。在5例分析病例中，细胞遗传学变化数量较少（中位数，4;范围，1-7），无7三体或1 - 7三体。乳头状结构，坏死和免疫组化的配置文件反对的诊断嗜酸细胞瘤，并建议我们的案件是乳头状肾细胞癌组的一部分。然而，这些病例对于1型乳头状癌（由于嗜酸细胞和缺乏17三体）和2型乳头状癌（由于良好的结局）是非典型的。这些结果表明，成人乳头状肾肿瘤与嗜酸细胞可能是一个独特的变异乳头状肾细胞癌组。
We report a series of 10 oncocytic renal papillary tumors, with the aim of determining their clinicopathologic features. All patients were male (median age, 71 years), treated by radical nephrectomy and free of recurrence or metastasis (median follow-up, 62 months). Tumors (median size, 3.3 cm) were intrarenal and well limited, with no extrarenal extension. They consisted of thin, nonfibrotic papillae lined by a single layer of oncocytic cells, with finely granular eosinophilic cytoplasm and round regular nucleus exhibiting central nucleolus (Fuhrman grade II, except for one grade III). Foci of necrosis were present in most cases. All tumors were immunoreactive for alpha-methylacyl-coenzyme A racemase, vimentin, and CD10; 4 expressed renal cell carcinoma antigen and 3 cytokeratin 7. There were a low number of cytogenetic changes in the 5 analyzed cases (median, 4; range, 1-7), with no trisomy 7 or 17. Papillary architecture, necrosis, and immunohistochemical profiles argued against the diagnosis of oncocytoma and suggested our cases to be part of the papillary renal cell carcinoma group. However, the cases were atypical for type 1 papillary carcinoma (due to oncocytic cells and absence of trisomy 17) and for type 2 (due to a good outcome). These results suggest that adult papillary renal tumors with oncocytic cells might be a distinct variant in the papillary renal cell carcinoma group.