tfe3重排肾细胞癌的细胞形态学及临床病理相关性

IF 2.6 3区 医学 Q3 ONCOLOGY
Tieying Hou MD, PhD, Xiaoqi Lin MD, PhD
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引用次数: 0

摘要

背景TFE3重排肾细胞癌(TFE3- rrcc)含有涉及TFE3与许多不同的伴侣基因之一的基因融合。由于其不同的形态,鉴别诊断是广泛和具有挑战性的。关注TFE3-rRCC细胞形态学的出版物很少。方法收集12例TFE3-rRCC患者15例细胞学检查结果,其中原发肾7例,转移肾8例。结果细胞学检查显示肿瘤细胞具有中等颗粒状或空泡状细胞质,排列方式多样,如三维簇状、巢状/片状、孤立细胞、乳头状和管状/泡状结构。肿瘤细胞表现为偏心、圆形或卵圆形细胞核增大,可能位于周围,核仁小至突出,核膜不规则。偶见巨噬细胞、透明球或坏死。核和细胞块组织学常表现为乳头状突起,细胞核面向表面。肿瘤细胞也呈巢状、片状和管状排列。肿瘤细胞对TFE3(100%)、AMACR(100%)、PAX8(88%)和CD10(83%)有免疫反应,对CA9(64%)、CK7(20%)和CD117(25%)有局灶性染色。通过荧光原位杂交或RNA融合新一代测序检测,15例中有13例证实TFE3重排。12例患者中有9例(80%)出现转移,以腹膜后淋巴结为最常见的部位,其次是远处淋巴结、肺、脑、肾上腺和骨。单独行肾切除6例(50%),单独行化疗2例(17%),联合行肾切除+化疗4例(33%)。结论及时识别TFE3-rRCC不同的细胞形态学和组织形态学特征对准确诊断和有效治疗至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Cytomorphology and clinicopathologic correlation of TFE3-rearranged renal cell carcinoma

Cytomorphology and clinicopathologic correlation of TFE3-rearranged renal cell carcinoma

Background

TFE3-rearranged renal cell carcinoma (TFE3-rRCC) harbors gene fusions involving TFE3 with one of many different partner genes. Because of their diverse morphologies, the differential diagnosis is broad and challenging. Publications focusing on the cytomorphology of TFE3-rRCC are sparse.

Methods

Fifteen cytology cases of TFE3-rRCC from 12 patients were retrieved, comprising seven primary kidney cases and eight metastatic cases.

Results

Cytology smears showed tumor cells with moderate granular or vacuolated cytoplasm, arranged in diverse patterns, such as three-dimensional clusters, nested/sheeted formations, isolated cells, papillary, and tubular/acinar structures. The tumor cells exhibited enlarged eccentric, round or oval nuclei, possibly situated peripherally, with small to prominent nucleoli and irregular nuclear membranes. Macrophages, hyalinized globules, or necrosis were occasionally seen. Core and cell block histology often showed papillae with surface-oriented nuclei. Tumor cells were also arranged in nested, sheeted, and tubular patterns. Tumor cells were immunoreactive to TFE3 (100%), AMACR (100%), PAX8 (88%), and CD10 (83%) and showed focal staining for CA9 (64%), CK7 (20%), and CD117 (25%). TFE3 rearrangement was confirmed in 13 of 15 cases through fluorescence in situ hybridization or RNA fusion next-generation sequencing testing. Metastasis was observed in nine of 12 patients (80%), with retroperitoneal lymph nodes being the most common site, followed by distant lymph nodes, lung, brain, adrenal gland, and bone. Six patients (50%) underwent nephrectomy alone, two patients (17%) received chemotherapy alone, and four patients (33%) received combined nephrectomy and chemotherapy.

Conclusions

Timely recognition of TFE3-rRCC’s distinct cytomorphologic and histomorphologic features is essential for accurate diagnosis and effective treatment.

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来源期刊
Cancer Cytopathology
Cancer Cytopathology 医学-病理学
CiteScore
7.00
自引率
17.60%
发文量
130
审稿时长
1 months
期刊介绍: Cancer Cytopathology provides a unique forum for interaction and dissemination of original research and educational information relevant to the practice of cytopathology and its related oncologic disciplines. The journal strives to have a positive effect on cancer prevention, early detection, diagnosis, and cure by the publication of high-quality content. The mission of Cancer Cytopathology is to present and inform readers of new applications, technological advances, cutting-edge research, novel applications of molecular techniques, and relevant review articles related to cytopathology.
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