浆液细胞学中肾细胞癌的原发肿瘤特征和免疫组化特征。

Q2 Medicine
Mason Marshall DO , Sigfred Lajara MD , Gabriela Quiroga-Garza MD , Dimitrios Korentzelos MD , Maedeh Mohebnasab MD , Samer Khader MD
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引用次数: 0

摘要

导读:肾细胞癌(RCC)在2%-3%的病例中累及浆膜表面,因此很少有论文描述RCC累及浆液细胞学(SFC)。这种诊断是具有挑战性的,因为它的罕见性,难以描述的细胞形态学特征和广泛使用的上皮标志物MOC31和BerEP4的罕见表达。我们描述了我们在SFC标本中处理RCC的机构经验。方法:查询我院实验室信息系统2013 - 2023年RCC患者SFC标本。登记为“怀疑有恶性细胞”及“恶性细胞呈阳性”的个案亦包括在内。记录患者人口统计学、免疫组化结果、原发肿瘤特征和分子数据。结果:61例,胸膜标本50例,腹膜标本11例。50例为恶性肿瘤阳性,11例为恶性肿瘤可疑。MOC31和BerEP4分别在59%和55%的病例中呈阳性。PAX-8、CA9、CD10和RCC分别在85%、82%、73%和29%的病例中呈阳性。原发肿瘤组织学亚型包括39个透明细胞型,6个乳头状型,1个憎色型,15个未进一步亚分类。59%的病例有4%的核分级,37%有肉瘤样或横纹肌样分化。71%的病例为3期或4期。结论:在疾病分期高、核分级高、肉瘤样或横纹肌样分化的患者中,RCC更容易转移到浆膜表面。在这种情况下,MOC31和BerEP4表现不佳。我们建议添加细胞角蛋白、PAX-8、CD10和CA-9来确认转移性病变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Primary tumor characteristics and immunohistochemical profile of renal cell carcinoma in serous fluid cytology

Introduction

Renal cell carcinoma (RCC) involves serosal surfaces in 2%-3% of cases, and thus few papers describe serous fluid cytology (SFC) involvement by RCC. This diagnosis is challenging, given its rarity, nondescript cytomorphologic features and infrequent expression of widely used epithelial markers MOC31 and BerEP4. We describe our institutional experience with RCC in SFC specimens.

Materials and methods

Our institutional laboratory information system was queried for SFC specimens from patients with RCC between 2013 and 2023. Cases signed out as “Suspicious for Malignant Cells” and “Positive for Malignant Cells” were included. Patient demographics, immunohistochemical results, primary tumor characteristics, and molecular data were recorded.

Results

Sixty-one cases, 50 pleural, and 11 peritoneal fluid specimens were identified. Fifty (50) were signed out as positive for malignancy and 11 were signed out as suspicious for malignancy. MOC31 and BerEP4 were positive in 59% and 55% of cases, respectively. PAX-8, CA9, CD10, and RCC were positive in 85%, 82%, 73%, and 29% of cases, respectively. Primary tumor histologic subtypes included 39 clear cell, 6 papillary, 1 chromophobe, and 15 were not further subclassified. Fifty-nine percent (59%) of cases had a nuclear grade of 4%, and 37% had sarcomatoid or rhabdoid differentiation. Seventy-one percent (71%) of cases had stage 3 or 4 disease.

Conclusions

RCC metastases to serosal surfaces are more likely to be seen in patients with higher disease stage, high nuclear grade, and sarcomatoid or rhabdoid differentiation. MOC31 and BerEP4 performed poorly in this setting. We recommend the addition of cytokeratins, PAX-8, CD10, and CA-9 to confirm metastatic involvement.
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来源期刊
Journal of the American Society of Cytopathology
Journal of the American Society of Cytopathology Medicine-Pathology and Forensic Medicine
CiteScore
4.30
自引率
0.00%
发文量
226
审稿时长
40 days
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