Pathology International最新文献

{"title":"Clinical impact of perineural cancer invasion detected in prostate cores: Involvement of spatially contiguous versus separate biopsy sites.","authors":"Yuki Teramoto,&nbsp;Numbereye Numbere,&nbsp;Hiroshi Miyamoto","doi":"10.1111/pin.13356","DOIUrl":"10.1111/pin.13356","url":null,"abstract":"To the Editor, The presence of perineural invasion (PNI) by prostate cancer, particularly on biopsy, has been associated with adverse pathology, including extra‐prostatic extension as the suggested main route of cancer spread out of the prostate. Recently, we have additionally found that PNI in multiple biopsy sites (vs. single site) or both right and left biopsy sites (vs. two unilateral sites) is an independent prognosticator in prostate cancer patients undergoing radical prostatectomy. The present study aimed to further determine the clinical significance of biopsy PNI detected in potentially contiguous versus separate lesion(s). In one of our previous studies, we assessed radical prostatectomy findings and postoperative oncologic outcomes in men with prostate cancer exhibiting PNI in only two of the sextant biopsy sites (i.e., right apex, right mid, right base, left apex, left mid, left base). We then compared unilateral (n = 140; two of either right or left sites) versus bilateral (n = 30; one of right sites and one of left sites) PNI cohorts and found that bilateral PNI was strongly associated with a poorer prognosis, but not worse histopathologic features on biopsy or prostatectomy. We herein used the same cohort of these 170 patients. Data were analyzed, using the Student's t test for continuous variables, as well as the χ test or Fisher's exact test for noncontinuous variables. Progression‐free survival was assessed by the Kaplan–Meier method and the Gehan–Breslow–Wilcoxon test, while disease progression was separately defined as a single prostate‐ specific antigen (PSA) level of ≥0.2 ng/mL or the introduction of adjuvant therapy in patients with no adjuvant therapy immediately after prostatectomy (n = 125) and as an increase in PSA value of ≥2 ng/mL or the introduction of salvage therapy in those undergoing immediate adjuvant therapy (n = 45). In addition, the Cox proportional hazards model was used to determine statistical significance of prognostic factors in a multivariable setting. A p‐value of <0.05 was considered to be statistically significant. We thus retrospectively examined 170 sets of prostate biopsy showing PNI in two of six sites and corresponding radical prostatectomy. These did not include any cases exhibiting PNI on targeted biopsy or undergoing neoadjuvant therapy prior to prostatectomy. PNI was identified at spatially contiguous or separate site(s) (see Figure 1a) in 114 (67.1%) or 56 (33.9%) cases, respectively. Surgical margin was significantly (p =0.020) more often positive in the separate group (35.7%) than in the contiguous group (19.3%) (Supporting Information: Table S1). However, no significant differences were observed in other clinicopathologic features examined, including age at biopsy (p= 0.208), preoperative PSA (p= 0.434), number of cancer‐positive biopsy sites (p =0.325), Grade Group on biopsy (p= 0.765) or prostatectomy (p= 0.500), pT stage (p= 0.680), pN stage (p= 0.303), estimated tumor volume (p= 0.07","PeriodicalId":19806,"journal":{"name":"Pathology International","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10585126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological significance of TUBB3 in upper tract urothelial carcinoma and possible application in urine cytology.","authors":"Go Kobayashi,&nbsp;Tetsutaro Hayashi,&nbsp;Kazuhiro Sentani,&nbsp;Naohiro Uraoka,&nbsp;Takafumi Fukui,&nbsp;Aya Kido,&nbsp;Narutaka Katsuya,&nbsp;Akira Ishikawa,&nbsp;Takashi Babasaki,&nbsp;Yohei Sekino,&nbsp;Hiroyuki Nose,&nbsp;Nobuyuki Hinata,&nbsp;Naohide Oue","doi":"10.1111/pin.13362","DOIUrl":"https://doi.org/10.1111/pin.13362","url":null,"abstract":"<p><p>βIII-Tubulin, encoded by the TUBB3 gene, is a microtubule protein. We previously reported that TUBB3 is overexpressed in renal cell carcinoma. We investigated the clinicopathological significance of TUBB3 in upper tract urothelial carcinoma (UTUC) by immunohistochemistry. In normal tissue, TUBB3 expression was weak or absent. In contrast, TUBB3 overexpression was observed in urothelial carcinoma (UC) tissues in 51 (49%) of 103 UTUC cases. TUBB3 overexpression was associated with nodular/flat morphology, high-grade disease, high T stage, and a poor prognosis. Similar results were obtained in The Cancer Genome Atlas bladder cancer cohort. TUBB3 expression was also associated with high Ki-67 labeling index, CD44v9, HER2, EGFR, and p53 expression in UTUC. Among representative cancer-related molecules, TUBB3 was an independent predictor of progression-free survival and high-grade UC. Finally, using urine cytology samples, we analyzed TUBB3 expression by immunocytochemistry. TUBB3 expression was more frequently found in UC cells than in nonneoplastic cells. The diagnostic accuracy of urine cytology was improved when combined with TUBB3 immunostaining. The findings suggest the importance of TUBB3 in tumor progression and its potential application as a biomarker for high-grade disease and the prognosis of UC. Moreover, combination with TUBB3 immunostaining might improve the diagnostic accuracy of urine cytology.</p>","PeriodicalId":19806,"journal":{"name":"Pathology International","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10221729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible roles of human mast cells in the formation of xanthelasma palpebrarum.","authors":"Hiroya Nakamura,&nbsp;Takashi Matsuzaki,&nbsp;Ken R Ito,&nbsp;Ryota Nakagawa,&nbsp;Lurica M Asano,&nbsp;Hinako Nishikido,&nbsp;Hironori Haga,&nbsp;Tatsuki R Kataoka","doi":"10.1111/pin.13347","DOIUrl":"https://doi.org/10.1111/pin.13347","url":null,"abstract":"<p><p>Cutaneous xanthoma consist of foam cells that originate from monocytes or macrophages and accumulate in perivascular areas of the skin. The main component of these cells is oxidized low-density lipoprotein (oxLDL). In this study, we show that mast cells surround the accumulated foam cells, suggesting their involvement in xanthoma formation. Coculture of THP-1 or U937 monocytes with the human mast cell line LUVA upregulated their uptake of oxLDL. Positive staining for intracellular cell adhesion molecule-1 (ICAM-1) at the borders between mast cells and foam cells was seen in pathological specimens of the most common cutaneous xanthoma, xanthelasma palpebrarum, and in cocultures. In the latter, ICAM1 messenger RNA levels were upregulated. The administration of anti-ICAM-1 blocking antibody inhibited the increase in oxLDL uptake by THP-1 or U937 monocytes cocultured with LUVA. Taken together, these results suggest a role for mast cells in the formation of xanthelasma palpebrarum and the involvement of ICAM-1 in this process.</p>","PeriodicalId":19806,"journal":{"name":"Pathology International","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10584567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor heterogeneity from the viewpoint of pathologists.","authors":"Eiichi Morii","doi":"10.1111/pin.13366","DOIUrl":"https://doi.org/10.1111/pin.13366","url":null,"abstract":"<p><p>Morphological and functional heterogeneity are found in tumors, with the latter reflecting the different levels of resistance against antitumor therapies. In a therapy-resistant subpopulation, the expression levels of differentiation markers decrease, and those of immature markers increase. In addition, this subpopulation expresses genes involved in drug metabolism, such as aldehyde dehydrogenase 1A1 (ALDH1A1). Because of their similarity to stem cells, cells in the latter therapy-resistant subpopulation are called cancer stem cells (CSCs). Like normal stem cells, CSCs were originally thought not to arise from non-CSCs, but this hierarchical model is too simple. It is now believed that CSCs are generated from non-CSCs. The plasticity of tumor phenotypes between CSCs and non-CSCs causes difficulty in completely curing tumors. In this review, focusing on ALDH1A1 as a marker for CSCs or immature tumor cells, the dynamics of ALDH1A1-expressing tumor cells and their regulatory mechanisms are described, and the plausible regulatory mechanisms of plasticity of ALDH1A1 expression phenotype are discussed. Genetic mutations are a significant factor for tumorigenesis, but non-mutational epigenetic reprogramming factors yielding tumor heterogeneity are also crucial in determining tumor characteristics. Factors influencing non-mutational epigenetic reprogramming in tumors are also discussed.</p>","PeriodicalId":19806,"journal":{"name":"Pathology International","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10220214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Constant small-cell changes and variable LEF1 expression in DUSP22-rearranged primary cutaneous anaplastic large-cell lymphoma: Analysis of the repeated biopsies of three patients.","authors":"Akio Osakada,&nbsp;Masakazu Fujimoto,&nbsp;Chiyuki Ueshima,&nbsp;Yo Kaku,&nbsp;Momoko Nishikori,&nbsp;Norihito Inoue,&nbsp;Kengo Takeuchi,&nbsp;Hironori Haga","doi":"10.1111/pin.13360","DOIUrl":"https://doi.org/10.1111/pin.13360","url":null,"abstract":"<p><p>DUSP22-rearranged primary cutaneous anaplastic large-cell lymphoma (pcALCL) has a biphasic histological pattern defined by large dermal atypical lymphocytes and epidermotropic small lymphocytes resembling pagetoid reticulosis, but the positivity rate of the biphasic pattern in DUSP22-rearranged pcALCL is unknown. Immunohistochemically, LEF1 expression in >75% of tumor cells is associated with DUSP22-rearrangement (DUSP22-R) in systemic ALCL. However, whether this association applies to pcALCL remains unclear. To analyze these pathological clues for screening DUSP22-R, we reviewed 11 skin biopsies from three patients with DUSP22-rearranged pcALCL. All specimens showed a biphasic pattern, of which three showed nonpagetoid infiltration of the epidermis. In all lesions, small-cell changes of tumor cells were observed not only within the epidermis but also under the epidermis. LEF1 positivity rates varied by lesion (range: 30%-90%, mean: 59.6%) with only three patients expressing LEF1 in more than 75% of tumor cells. In conclusion, the biphasic pattern was a constant finding in DUSP22-rearranged pcALCL, but it was not always pagetoid reticulosis-like. The recognition of small-cell change outside the epidermis may be helpful in diagnosing DUSP22-rearranged pcALCL. However, LEF1 expression was variable and its diagnostic usefulness may be limited.</p>","PeriodicalId":19806,"journal":{"name":"Pathology International","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10219265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endotheliopathy of liver sinusoidal endothelial cells in liver disease.","authors":"Reiichiro Kondo,&nbsp;Yasuko Iwakiri,&nbsp;Masayoshi Kage,&nbsp;Hirohisa Yano","doi":"10.1111/pin.13361","DOIUrl":"https://doi.org/10.1111/pin.13361","url":null,"abstract":"<p><p>Liver is the largest solid organ in the abdominal cavity, with sinusoid occupying about half of its volume. Under liver disease, hemodynamics in the liver tissue dynamically change, resulting in injury to liver sinusoidal endothelial cells (LSECs). We discuss the injury of LSECs in liver diseases in this article. Generally, in noninflamed tissues, vascular endothelial cells maintain quiescence of circulating leukocytes, and unnecessary blood clotting is inhibited by multiple antithrombotic factors produced by the endothelial cells. In the setting of inflammation, injured endothelial cells lose these functions, defined as inflammatory endotheliopathy. In chronic hepatitis C, inflammatory endotheliopathy in LSECs contributes to platelet accumulation in the liver tissue, and the improvement of thrombocytopenia by splenectomy is attenuated in cases with severe hepatic inflammation. In COVID-19, LSEC endotheliopathy induced by interleukin (IL)-6 trans-signaling promotes neutrophil accumulation and platelet microthrombosis in the liver sinusoids, resulting in liver injury. IL-6 trans-signaling promotes the expression of intercellular adhesion molecule-1, chemokine (C-X-C motif) ligand (CXCL1), and CXCL2, which are the neutrophil chemotactic mediators, and P-selectin, E-selectin, and von Willebrand factor, which are involved in platelet adhesion to endothelial cells, in LSECs. Restoring LSECs function is important for ameliorating liver injury. Prevention of endotheliopathy is a potential therapeutic strategy in liver disease.</p>","PeriodicalId":19806,"journal":{"name":"Pathology International","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10221724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional structural analysis of papillary thyroid carcinoma nuclei with serial block-face scanning electron microscopy (SBF-SEM).","authors":"Tomohiro Inoue,&nbsp;Nobuhiko Ohno,&nbsp;Naoki Oishi,&nbsp;Kunio Mochizuki,&nbsp;Ryohei Katoh,&nbsp;Tetsuo Kondo","doi":"10.1111/pin.13329","DOIUrl":"https://doi.org/10.1111/pin.13329","url":null,"abstract":"<p><p>Nuclear morphology of carcinoma cells is critical for the pathological diagnosis of papillary thyroid carcinoma (PTC). However, three-dimensional architecture of PTC nuclei is still elusive. In this study, we analyzed the three-dimensional ultrastructure of PTC nuclei using serial block-face scanning electron microscopy which takes advantage of the high-throughput acquisition of serial electron microscopic images and three-dimensional reconstruction of subcellular structures. En bloc-stained and resin-embedded specimens were prepared from surgically removed PTCs and normal thyroid tissues. We acquired two-dimensional images from serial block-face scanning electron microscopy and reconstructed three-dimensional nuclear structures. Quantitative comparisons showed that the nuclei of carcinoma cells were larger and more complex than those of normal follicular cells. The three-dimensional reconstruction of carcinoma nuclei divided intranuclear cytoplasmic inclusions into \"open intranuclear cytoplasmic inclusions\" connecting to cytoplasm outside the nucleus and \"closed intranuclear cytoplasmic inclusions\" without that connection. Cytoplasm with abundant organelles was observed in open inclusions, but closed inclusions contained fewer organelles with or without degeneration. Granules with a dense core were only observed in closed inclusions. Our observations suggested that open inclusions originate from nuclear invaginations, and disconnection from cytoplasm leads to closed inclusions.</p>","PeriodicalId":19806,"journal":{"name":"Pathology International","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10038029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paragonimus westermani preadult fluke in a pulmonary necrotizing granulomatous lesion: A case associated with eating soy sauce-marinated raw freshwater crab, \"gejang\".","authors":"Kazunari Maekawa,&nbsp;Eiji Nagayasu,&nbsp;Youichi Hata,&nbsp;Fumio Hanamure,&nbsp;Haruhiko Maruyama,&nbsp;Atsushi Yamashita","doi":"10.1111/pin.13352","DOIUrl":"https://doi.org/10.1111/pin.13352","url":null,"abstract":"To the Editor, Pulmonary paragonimiasis is a parasitic disease caused by the Paragonimus species. Infection occurs by ingesting raw freshwater crabs contaminated with Paragonimus metacercariae or wild boar or wild deer meat contaminated with Paragonimus juvenile worms. Pulmonary lesions are local inflammatory reactions to the Paragonimus worms or eggs, characterized by rich eosinophils and necrotizing granulomas, and can form abscesses and cysts. In practice, pathologists rarely have the opportunity to investigate surgical specimen because paragonimiasis can be diagnosed in clinical settings, including typical symptoms, peripheral eosinophilia, and radiographic findings together with detecting Paragonimus eggs in sputum and/or fecal samples. Furthermore, treatment with oral praziquantel is usually successful, and surgical resection is generally unnecessary. Thus, there is limited information on the pathological findings of lung lesions in recent studies. Here, we describe a case of paragonimiasis with a necrotizing granulomatous lesion and a preadult fluke in the resected lung. Paragonimus species were identified by DNA sequencing using formalin‐fixed paraffin‐embedded tissues. A 60‐year‐old woman from Korea was admitted to our hospital for productive cough and hemoptysis for 4 months. The patient had peripheral blood eosinophilia (2100 cells/μL). Computed tomography showed a 28‐mm solitary nodule with peripheral spiculation in the right lower lobe (Figure 1a). Cytological examination of the sputum revealed prominent eosinophils, but neither malignant cells nor Paragonimus eggs were detected. She underwent a right lower lobectomy for a clinical diagnosis of lung cancer. At the cut surface of the formalin‐fixed lung, a 25 × 25mm brownish lesion with irregular single cavity formation was observed (Figure 1b). In addition, there was a 5‐mm long, flat ellipsoid, and light‐pink object in the cavity (Figure 1c). Histologically, the body had a periodic acid Schiff‐positive tegument, a pair of digestive tracts, and an excretory bladder. These findings suggested that the object was a fluke (Figure 1d). The pulmonary lesion showed necrotized granulomatous inflammation with infiltration of numerous eosinophils and plasma cells (Figure 1e), associated with numerous Charcot–Leyden crystals around the worm body (Supporting Information: Figure S1). There were no parasite eggs in the uterus of the worm or in the patient's tissue around the worm throughout the histological sections, while vitelline cells were noted in vitelline glands and vitelline ducts of the worm (Supporting Information: Figure S2). Moreover, there was no evidence of neoplastic lesions or bacterial and fungal colonies. These pathological findings suggested that the case was a pulmonary paragonimiasis of preadult stage. A multiple‐dot enzyme‐linked immunosorbent assay for the patient serum detected IgG antibodies for Paragonimus westermani and Paragonimus skrjabini miyazakii. To confirm the dia","PeriodicalId":19806,"journal":{"name":"Pathology International","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10020861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focal glioneuronal differentiation in an atypical teratoid/rhabdoid tumor after chemoradiotherapy.","authors":"Makiko Yoshida,&nbsp;Atsuro Saito,&nbsp;Daiichiro Hasegawa,&nbsp;Yoshiyuki Kosaka,&nbsp;Junji Koyama,&nbsp;Atsufumi Kawamura,&nbsp;Yoshinobu Akasaka,&nbsp;Toshinori Soejima","doi":"10.1111/pin.13354","DOIUrl":"https://doi.org/10.1111/pin.13354","url":null,"abstract":"Atypical teratoid/rhabdoid tumor (AT/RT) is a malignant brain tumor composed of poorly differentiated cells and a variable number of rhabdoid cells, with the potential to differentiate along neuroepithelial, epithelial","PeriodicalId":19806,"journal":{"name":"Pathology International","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10020856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, cytological, and pathological characteristics of metastatic renal cell carcinoma to the thyroid: A study of  14 cases at a Japanese single institution.","authors":"Aki Tanaka,&nbsp;Mitsuyoshi Hirokawa,&nbsp;Ayana Suzuki,&nbsp;Miyoko Higuchi,&nbsp;Akira Miyauchi,&nbsp;Takashi Akamizu","doi":"10.1111/pin.13344","DOIUrl":"https://doi.org/10.1111/pin.13344","url":null,"abstract":"<p><p>A preoperative diagnosis of metastatic renal cell carcinoma to the thyroid (MRCCT) is important for determining clinical management but is challenging even in cases with a clinical history of renal cell carcinoma (RCC). This study aimed to elucidate the clinical, cytological, and pathological characteristics of MRCCT. Fourteen MRCCT cases extracted from 18 320 malignant thyroid tumors were included in this study. Twelve MRCCT (85.7%) occurred as solitary lesions and the most frequently suspected lesions on ultrasonography were follicular tumors. On cytology, 46.2% of cases were reported as RCC or suspected RCC; a medical history of RCC and immunocytochemistry were helpful in interpretation. RCC metastasized to a follicular adenoma in 50.0% of the solitary lesions. MRCCTs with a long interval from the initial presentation, solitary lesion, and Ki-67 labeling index <10% showed significantly longer disease-free survival. MRCCT is characterized by a long interval from the initial presentation of RCC, appearance as a solitary nodule, ultrasonographic similarity to follicular tumors, sharing cytological findings with primary thyroid tumors, and high frequency of metastasis within follicular adenoma. A long interval from the initial presentation, occurrence as a solitary lesion, and low Ki-67 labeling index may be favorable prognostic factors.</p>","PeriodicalId":19806,"journal":{"name":"Pathology International","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9975546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}