嫌色性肾细胞癌的组织学特征

V. Baranovska, A. Romanenko, L. Zakhartseva
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We used data from histories of disease and histological postoperative material of 198 patients with chromophobe renal cell carcinoma and renal oncocytoma. After the diagnosis was confirmed, we described the histological features of the tumors and calculated their relative prevalence amongst the renal oncocytoma and chromophobe renal cell carcinoma tissues. To conclude, we identified the histological features that are more likely to be present in the case of chromophobe renal cell carcinoma.\n\nConclusions. Chromophobe renal cell carcinomas are present in 31 % of our samples. Tumors are more prevalent in patients in their sixth and seventh decade. Most chromophobe renal cell carcinomas are unilateral.\n\nChromophobe renal cell carcinomas have a polymorphic histological structure. The classic variant of chromophobe renal cell carcinoma is more common than the eosinophilic one. A mixed variant of chromophobe renal cell carcinoma is present in a minority of cases. 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引用次数: 0

摘要

介绍。肾肿瘤是一种常见病。鉴于其中一些肿瘤(如肾细胞癌)是良性的,而另一些肿瘤(如憎色肾细胞癌)是恶性的,因此有必要对不同亚型的肿瘤进行鉴别诊断,以便进行预后和治疗。不幸的是,这些肿瘤之间的组织学相似性使得准确诊断变得困难。在某些情况下,应使用额外的诊断方法,如免疫组织化学。本研究的目的是分析憎色性肾细胞癌和肾嗜瘤细胞瘤的组织学特征,以明确其病理特征,从而确定其诊断。材料和方法。我们使用了198例憎色性肾细胞癌和肾嗜瘤细胞瘤患者的病史和术后组织学资料。确诊后,我们描述了肿瘤的组织学特征,并计算了它们在肾嗜铬细胞瘤和嫌色肾细胞癌组织中的相对患病率。总之,我们确定了在憎色性肾细胞癌病例中更可能出现的组织学特征。在我们的样本中,有31%存在憎色性肾细胞癌。肿瘤在六七十岁的患者中更为普遍。大多数憎色性肾细胞癌是单侧的。嫌色性肾细胞癌具有多形性的组织结构。典型的憎色性肾细胞癌比嗜酸性肾细胞癌更为常见。在少数病例中存在厌色性肾细胞癌的混合变体。ChRCC最常见的特征是固体和肺泡生长模式,细胞质清晰网状,细胞核呈葡萄干状。在比较肾嗜色细胞瘤与憎色性肾细胞癌中各种组织学特征的相对患病率后,我们能够确定,憎色性肾细胞癌往往比肾嗜色性肾细胞癌更常表现出以下特征:不同的核大小,类葡萄干核,网状细胞质,透明细胞质。前文提到的特殊特征可能出现在肿瘤组织的一小部分,因此,在分析过程中经常被遗漏,这可能导致误诊。为了降低这种风险,我们建议对肿瘤组织进行大样本分析,并使用添加性方法,如免疫组织化学与生物标志物cd10 (56C6), cd68 (KP1), Cytokeratin 7 (v - tl 12/30), CD117/c-kit, Vim3B4, S-100 (4C4.9)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
HISTOLOGICAL FEATURES OF CHROMOPHOBE RENAL CELL CARCINOMA
Introduction. Renal neoplasms are a common disease. Differential diagnostics of different tumor subtypes for prognosis and treatment is necessary given that some of them, like renal cell oncocytomas, are benign, and others, like chromophobe renal cell carcinomas, are malignant. Unfortunately, the histological similarity between these tumors makes accurate diagnostics difficult. In some cases, additional diagnostic methods such as immunohistochemistry should be used. The aim of our study is to analyze the histological characteristics of chromophobe renal cell carcinomas and renal oncocytomas, in order to specify their pathognomonic features, allowing for the confirmation of the diagnosis. Materials and methods. We used data from histories of disease and histological postoperative material of 198 patients with chromophobe renal cell carcinoma and renal oncocytoma. After the diagnosis was confirmed, we described the histological features of the tumors and calculated their relative prevalence amongst the renal oncocytoma and chromophobe renal cell carcinoma tissues. To conclude, we identified the histological features that are more likely to be present in the case of chromophobe renal cell carcinoma. Conclusions. Chromophobe renal cell carcinomas are present in 31 % of our samples. Tumors are more prevalent in patients in their sixth and seventh decade. Most chromophobe renal cell carcinomas are unilateral. Chromophobe renal cell carcinomas have a polymorphic histological structure. The classic variant of chromophobe renal cell carcinoma is more common than the eosinophilic one. A mixed variant of chromophobe renal cell carcinoma is present in a minority of cases. The most common features of ChRCC are solid and alveolar growth patterns, clear and reticular cytoplasm, raisinoid nuclei. After comparing the relative prevalence of various histological features in renal oncocytomas to those present in chromophobe renal cell carcinomas, we are able to ascertain that chromophobe renal cell carcinomas tend to exhibit the following features significantly more often than renal oncocytomas: differing nuclear size, raisinoid nuclei, reticular cytoplasm, clear cytoplasm. The particular features mentioned in the preceding paragraph, can be present on a small subset of the tumor tissue, and are thus, often missed during analysis, which can lead to misdiagnosis. In order to mitigate this risk, we recommend analyzing a big sample of tumor tissue and using additive methods such as immunohistochemistry with biomarkers CD 10 (56C6), CD 68 (KP1), Cytokeratin 7 (OV-TL 12/30), CD117/c-kit, Vimentin (Vim3B4), S-100 (4C4.9).
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