Clear cell papillary cystadenoma of the epididymis and mesosalpinx - Immunohistochemical differentiation from metastatic clear cell renal cell carcinoma
Clear cell papillary cystadenoma of the epididymis and mesosalpinx - Immunohistochemical differentiation from metastatic clear cell renal cell carcinoma
复制标题
DOI：
10.1097/01.pas.0000155160.36154.ml
复制
发表时间：
2005-04-01
影响因子：
5.6
通讯作者：
Epstein, JI
中科院分区：
文献类型：
--
作者：
Aydin, H;Young, RH;Epstein, JI
透明细胞乳头状囊腺瘤是一种罕见的附睾上皮性肿瘤，可表现为孤立的病变或von Hippel-Lindau病(VHLD)的组成部分。最近，女性生殖道中的肿瘤也有类似的组织学描述。透明细胞乳头状囊腺瘤的识别是至关重要的，因为它与VHLD有关，而且由于其共同的结构和透明细胞，它可能与转移性肾细胞癌相混淆。在这项研究中，我们报告了5例透明细胞乳头状囊腺瘤，3例附睾和2例输卵管系膜透明细胞乳头状囊腺瘤来自转移性肾癌的免疫组织化学分化。2例有肾细胞癌病史，其中1例附睾乳头状囊腺瘤最初被认为是转移性肾细胞癌。免疫组织化学染色显示，肿瘤细胞角蛋白AE1/AE3和上皮膜抗原呈中等强度阳性，CK7呈强阳性，CK20和RCC阴性。5例中有4例CD10阴性。这一染色图谱与已报道的肾透明细胞癌形成对比，后者通常CK7阴性，肾细胞癌(RCC)和CD10免疫反应阳性。我们的发现表明，在透明细胞乳头状囊腺瘤的组织学诊断不确定的情况下，上述免疫组织化学检查有助于排除转移性肾细胞癌。
Clear cell papillary cystadenoma is a rare epithelial tumor of the epididymis, which may present as an isolated lesion or as a component of von Hippel-Lindau disease (VHLD). Recently, tumors have also been described in the female genital tract with similar histology. Recognition of clear cell papillary cystadenoma is critical because of its association with VHLD and its potential diagnostic confusion with metastatic renal cell carcinoma because of a shared architecture and clear cells. In this study, we report on the immunohistochemical differentiation of 5 clear cell papillary cystadenomas, 3 of the epididymis and 2 of the mesosalpinx, from metastatic renal cell carcinoma. In 2 cases, there was a history of renal cell carcinoma in the setting of VHLD; and in 1 of these cases, an epididymal papillary cystadenoma was initially considered to be metastatic renal cell carcinoma. Immunohistochemically, tumor cells were moderately intensely positive for cytokeratin AE1/AE3 and epithelial membrane antigen, strongly positive for CK7 and negative for CK20 and RCC. Four of 5 cases were negative for CD10. This staining profile contrasts with that reported for clear cell renal cell carcinomas, which are typically negative for CK7 and immunoreactive for renal cell carcinoma (RCC) and CD10. Our findings indicate that, in cases where there is uncertainty about the histologic diagnosis of clear cell papillary cystadenoma, the above immunohistochemical panel helps to rule out metastatic renal cell carcinoma.