Oncocytic papillary renal cell carcinoma: a clinicopathologic, immunohistochemical, ultrastructural, and interphase cytogenetic study of 12 cases.
Oncocytic papillary renal cell carcinoma: a clinicopathologic, immunohistochemical, ultrastructural, and interphase cytogenetic study of 12 cases.
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DOI：
10.1016/j.anndiagpath.2005.12.002
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发表时间：
2006-06-01
影响因子：
2
通讯作者：
Martignoni, Guido
中科院分区：
文献类型：
--
作者：
Hes, Ondrej;Brunelli, Matteo;Martignoni, Guido
乳头状肾细胞癌（RCC）可分为1型和2型，前者表现为单薄的苍白细胞质，后者表现为嗜酸性细胞质的假分层细胞。然而，通过识别少数具有不同形态特征的病例，可以推断存在更多的乳头状RCC变异。我们报告了12例由肿瘤细胞组成的乳头状肾细胞癌的临床病理、免疫组织化学、超微结构和间期细胞遗传学特征。男性10例，中位年龄67岁。肿瘤边界清晰，中位直径7.1 cm。11例出现实性癌细胞样区。肿瘤细胞细胞质内充满带板状嵴的线粒体。所有病例抗线粒体抗原和消旋酶阳性，细胞角蛋白（AE1/AE3、CK8-18、CK7、CK19）、EMA、CD10、vimentin和小白蛋白均表现出不同的免疫反应性。每1个高倍视场检测到0 ~ 6个细胞的MIB1。福尔马林固定石蜡包埋组织的荧光原位杂交分析显示，7号染色体和17号染色体有3个或更多的信号（在12个肿瘤中，7个肿瘤的细胞核均为>或=30%）。在男性中，Y染色体的信号在80%以上的肿瘤细胞核中缺失。一名患者死于转移。荧光原位杂交的间期细胞遗传学分析可以作为模拟嗜瘤细胞瘤病例的诊断工具。
Papillary renal cell carcinoma (RCC) is subclassified in type 1 displaying cells with scanty pale cytoplasm arranged in a single layer and in type 2 showing pseudostratified cells with eosinophilic cytoplasm. However, the existence of more variants of papillary RCC may be inferred by the recognition of few cases with different morphological features. We report the clinicopathologic, immunohistochemical, ultrastructural, and interphase cytogenetic features of 12 papillary RCC composed by oncocytes. Ten patients were males and their median age was 67 years. The tumors were well demarcated and their median diameter was 7.1 cm. Solid oncocytoma-like areas occurred in 11 cases. The cytoplasm of the neoplastic cells was filled by mitochondria with lamellar cristae. All cases were positive for the antimitochondrial antigen and racemase and showed variable immunoreactivity for cytokeratins (AE1/AE3, CK8-18, CK7, CK19), EMA, CD10, vimentin, and parvalbumin. MIB1 was detected in 0 to 6 cells per 1 high-power field. Fluorescent in situ hybridization analysis on formalin-fixed paraffin-embedded tissue showed three or more signals for chromosome 7 and 17 (for both > or =30% of nuclei in 7 of 12 neoplasms). In males, signals of chromosome Y were absent in more than 80% of the neoplastic nuclei. One patient died of metastases. Interphase cytogenetic analysis by fluorescent in situ hybridization can be a diagnostic tool in cases mimicking an oncocytoma.