Oncocytic papillary renal cell carcinoma with solid architecture: Mimic of renal oncocytoma
Oncocytic papillary renal cell carcinoma with solid architecture: Mimic of renal oncocytoma
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DOI：
10.1111/j.1440-1827.2007.02205.x
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发表时间：
2008-03
影响因子：
2.2
通讯作者：
K. Mai;D. Kohler;S. Robertson;E. Belanger;E. Marginean
中科院分区：
文献类型：
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作者：
K. Mai;D. Kohler;S. Robertson;E. Belanger;E. Marginean
乳头状肾细胞癌（PRCC）可显示广泛的实性和非乳头状结构区域以及广泛的嗜酸性细胞质区域。11例嗜酸细胞性肾细胞肿瘤（ORCN）的组织病理学特征构成了肾细胞癌（RCC）与嗜酸细胞特征和肾嗜酸细胞瘤（RO）之间的诊断问题。肿瘤边界清楚或包膜完整，呈实性和弥漫性生长。非常偶尔乳头被认为是在4和肿瘤坏死的11。6例ORCN显示CD 117 +/孕激素受体（PR）+免疫表型（RO共有的特征），5例肿瘤显示CD 117-/PR-免疫表型（RCC共有的特征）。CD 117-/PR-ORCN还显示α-甲基酰基-辅酶A消旋酶和RCC抗原反应性以及对细胞角蛋白7、波形蛋白和CD 10的不同反应性（嗜酸性PRCC的特征）。这5例患者的肿瘤大小为1 - 6 cm。后一组中有2例患者发生疾病进展伴转移。总之，实体结构的嗜酸细胞型肾癌是一种罕见的肾癌。这种癌经常引起与RO的鉴别诊断问题，并且与常见类型的PRCC具有相似的免疫组织化学特性。细胞遗传学和分子生物学研究尚未进行这种变异的肾细胞癌。
Papillary renal cell carcinoma (PRCC) can display extensive areas of solid and non‐papillary architecture and extensive areas with oncocytic cytoplasm. Eleven oncocytic renal cell neoplasms (ORCN) with histopathological features posing a diagnostic problem between renal cell carcinoma (RCC) with oncocytic features and renal oncocytoma (RO) were identified. The neoplasms were well circumscribed or encapsulated tumors with solid and diffuse growth pattern. Very occasional papillae were seen in four and tumoral necrosis in two of 11. Six ORCN displayed a CD117+/progesterone receptor (PR)+ immunophenotype (feature shared by RO) and five tumors displayed a CD117–/PR– immunophenotype (feature shared by RCC). The CD117–/PR– ORCN also displayed α‐methylacyl‐coenzyme A racemase and RCC antigen reactivity as well as varying reactivity for cytokeratin 7, vimentin and CD10 (features of oncocytic PRCC). These five cases had tumor sizes ranging from 1 to 6 cm. Two patients in the latter group developed progression of the disease with metastases. In conclusion, oncocytic PRCC with solid architecture is a rare type of RCC. The carcinoma often poses differential diagnostic problems with RO and has similar immunohistochemical properties to the common type of PRCC. Cytogenetic and molecular studies have not been performed yet for this variant of RCC.