Acquired cystic disease-associated renal tumors:: an immunohistochemical and fluorescence in situ hybridization study

Acquired cystic disease-associated renal tumors:: an immunohistochemical and fluorescence in situ hybridization study
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DOI:
10.1038/modpathol.3800604
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发表时间:
2006-06-01
期刊:
影响因子:
7.5
通讯作者:
Cheng, Liang
Cheng, Liang
中科院分区:
医学1区
文献类型:
--
作者:
Cossu-Rocca, Paolo;Eble, John N.;Cheng, Liang

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终末期肾病与肾细胞肿瘤的发生率增加有关。其中,最近的研究已经确定了具有不寻常组织学模式的肿瘤,这些模式不适合当前分类系统中公认的类别。这些肿瘤常发生于肾脏获得性囊性病变,主要由大的嗜酸性细胞组成,排列成实性、筛状、腺泡状或乳头状。它们还含有草酸钙晶体的沉积物。我们研究了三个嗜酸性上皮肿瘤发生在肾脏获得性囊性疾病的三名患者。每个肿瘤都由大的嗜酸性细胞组成,排列成实体、腺泡或管状结构。每个肿瘤中都有草酸钙晶体沉积。黑尔胶体染色显示其中一个肿瘤的胞浆阳性反应。免疫组化显示CD 10(3/3)、AE 1/AE 3(3/3)、α-甲酰基-CoA消旋酶(2/3)、CAM 5.2(2/3)和波形蛋白(1/3)阳性。上皮膜抗原、细胞角蛋白7和高分子量细胞角蛋白(34 bE 12)的反应均为阴性。荧光原位杂交分析显示,1,2,6,10,或17号染色体在一个肿瘤中没有损失或增益。2例肿瘤中有1、2、6号染色体获得。其中一个肿瘤还显示出10号染色体的增加。与获得性囊性疾病相关的嗜酸性肾细胞肿瘤的免疫表型和遗传学特征与目前肾细胞瘤形成分类中的肾细胞肿瘤不同,应被视为肾细胞瘤形成谱中一种独特的临床病理学实体。
End-stage renal disease is associated with an increased incidence of renal cell neoplasms. Among these, recent studies have identified tumors with unusual histological patterns that do not fit into the categories recognized in the current classification system. These tumors often occur in kidneys with acquired cystic disease and are composed mainly of large eosinophilic cells arranged in solid, cribriform, acinar, or papillary patterns. They also contain deposits of calcium oxalate crystals. We investigated three eosinophilic epithelial tumors arising in kidneys with acquired cystic disease from three patients. Each of the tumors was composed of large eosinophilic cells arranged in solid, acinar, or tubulocystic architecture. Deposits of calcium oxalate crystals were present in each tumor. Hale's colloidal stain showed a positive cytoplasmic reaction in one of the neoplasms. Immunohistochemistry displayed positive results for CD10 (3/3), AE1/AE3 (3/3), alpha-methylacyl-CoA racemase (2/3), CAM5.2 (2/3), and vimentin (1/3). Reactions for epithelial membrane antigen, cytokeratin 7, and high molecular weight cytokeratin (34bE12) were negative. Fluorescence in situ hybridization analysis showed no losses or gains of chromosomes 1, 2, 6, 10, or 17 in one tumor. There were gains of chromosomes 1, 2, and 6 in two tumors. One of these tumors also showed gains of chromosome 10. Eosinophilic renal cell tumors associated with acquired cystic disease have immunophenotypes and genetic profiles distinct from the renal cell neoplasms recognized in the current classification of renal cell neoplasia, and should be considered as a distinct clinicopathologic entity in the spectrum of renal cell neoplasia.