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Shafique Ahmed Khan M, Dhandore P, Hombalkar N. Congenital mesoblastic nephroma beyond infancy. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_362_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Dharmalingam P, MukundaPai M, Nargund A, Champaka G, Kavitha BL, Okaly GVP, Madhu SD, Arun Kumar AR. Doing More with Less: Fine Needle Aspiration Cytology in Pediatric Neoplasms. J Cytol 2021; 38:127-132. [PMID: 34703088 PMCID: PMC8489700 DOI: 10.4103/joc.joc_197_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 04/05/2021] [Accepted: 06/21/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Cancer is one of the leading causes of death in the pediatric age group following infections. Among the diagnostic modalities, fine needle aspiration cytology (FNAC) is increasingly recognized as it permits rapid diagnosis with low cost and complication. In this study, we emphasize the diagnostic value of FNAC and describe the cytomorphological spectrum of tumors diagnosed on FNAC in pediatric patients with or without the aid of ancillary tests. Materials and Methods: This retrospective study included a total of 614 patients under the age of 15 years for whom fine needle aspiration (FNA) was done during a period of 3 years with or without guidance. The cytology smears were reviewed, and the morphological spectrum was analyzed with the ancillary studies. Results: Aspirates from children constituted around 3.5% of the total FNAC performed in our Institute. Of the 614 cases, 336 were male, and 278 were female with age under 15 years. Neoplastic cases constituted around 72%, which included benign (2%) and malignant (98%) tumors. The spectrum include hematolymphoid neoplasms in 39.3%, small round cell tumors (SRCT) in 24.9%, Wilms tumor in 9.2%, germ cell tumors in 4.8%, spindle cell neoplasms in 4.8%, hepatoblastoma in 3.2%, and osteosarcoma in 3% of the cases. The metastatic lesions constituted 8.1% of the cases diagnosed by FNA. Conclusion: FNA proves to be a reliable and efficien modality in diagnosing pediatric neoplasms in the hands of a skilled cytopathologist.
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Affiliation(s)
- Priya Dharmalingam
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - Malathi MukundaPai
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - Ashwini Nargund
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - G Champaka
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - B L Kavitha
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - Geeta V Patil Okaly
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - S D Madhu
- Department of Radiology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
| | - A R Arun Kumar
- Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
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Watabe S, Kikuchi Y, Mukaiyama J, Kato T, Sato K, Imanishi J, Torigoe T, Yazawa Y, Ishida T, Motoi T, Yasuda M, Uozaki H. Cytological features of BCOR-CCNB3 sarcoma: Comparison with Ewing sarcoma and synovial sarcoma. Cytopathology 2021; 32:771-778. [PMID: 34265123 DOI: 10.1111/cyt.13034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/07/2021] [Accepted: 07/06/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION BCOR-CCNB3 sarcoma (BCS) is one of the histological types classified as an undifferentiated small round cell sarcoma of bone and soft tissue. This sarcoma frequently develops in males under 20 years of age. Histologically, a delicate capillary network has been reported as a conspicuous finding. In this study, the cytological findings of BCS were observed in two cases of primary lesions and one case of a lung metastatic lesion. The cytological findings of BCS were compared with its histological mimics, and the characteristic findings of BCS were examined. METHODS Three cases of BCS were studied, and a cytological comparison was performed with 8 cases of Ewing sarcoma (ES) and 10 cases of synovial sarcoma (SS; monophasic type: 7 cases, biphasic type: 2 cases, poorly differentiated: 1 case). RESULTS In all BCS cases, small clusters with thin and delicate vascular cores and tiny vascular fragments were conspicuous. In ES and SS cases, although small clusters with vascular cores were observed, the vascular cores were thicker than in BCS, and no tiny vascular fragments appeared in most cases. Cytomorphological differences of tumour cells were also observed among BCS, ES, and SS. Predominantly rounded nuclei with fine chromatin and inconspicuous nucleoli can be cytological clues for BCS. CONCLUSIONS BCS shows characteristic cytological findings that make the diagnosis of BCS more likely than that of ES and SS. Cytological evaluation is a useful tool for appropriate differential diagnosis that leads to a more accurate final diagnosis and rapid treatment.
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Affiliation(s)
- Shiori Watabe
- Department of Pathology, Teikyo University School of Medicine, Tokyo, Japan
| | - Yoshinao Kikuchi
- Department of Pathology, Teikyo University School of Medicine, Tokyo, Japan
| | - Junji Mukaiyama
- Department of Pathology, Teikyo University Hospital, Tokyo, Japan
| | - Tomomi Kato
- Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Kenji Sato
- Department of Orthopaedics, Teikyo University School of Medicine, Tokyo, Japan
| | - Jungo Imanishi
- Department of Orthopaedics, Teikyo University School of Medicine, Tokyo, Japan
| | - Tomoaki Torigoe
- Department of Orthopaedics Oncology and Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yasuo Yazawa
- Department of Orthopaedics Oncology and Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Tsuyoshi Ishida
- Department of Diagnostic Pathology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Toru Motoi
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Masanori Yasuda
- Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hiroshi Uozaki
- Department of Pathology, Teikyo University School of Medicine, Tokyo, Japan
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Zhang Y, Li J, Wang Y. Clear cell sarcoma of the kidney in a 62-year-old patient presenting with generalized pruritus. BMC Cancer 2019; 19:1034. [PMID: 31676003 PMCID: PMC6823942 DOI: 10.1186/s12885-019-6212-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 09/27/2019] [Indexed: 11/25/2022] Open
Abstract
Background Clear cell sarcoma of the kidney (CCSK) is the second most common renal tumor in children following Wilms’ tumor. CCSK is extremely rare in adults, with only 25 adult cases reported in the medical literature. Case presentation We reported a 62-year-old man with a right renal mass presenting only with generalized pruritus who underwent radical right nephrectomy. With immunostaining, tumor cells were positive for expressed vimentin, neural cell adhesion molecule (NCAM, CD56), and Ki-67 and focally positive for p53, CD10 and Bcl-2. The histopathological diagnosis was CCSK. Two weeks after the operation, the generalized pruritus ended. One month after the operation, the patient started treatment with a regimen combining doxorubicin, vincristine, cyclophosphamide, and etoposide. At the 20-month follow-up visit, there was no evidence of local recurrence or metastases. Conclusions In a patient presenting with generalized pruritus, further evaluation for an underlying malignancy should be considered. It is difficult to distinguish CCSK from undifferentiated renal neoplasms. Immunohistochemistry could help to make exact histopathological diagnoses. The BCL-6 corepressor (BCOR) gene could play a significant role in CCSK tumorigenesis and be a good marker for CCSK diagnosis. Surgery with combination chemotherapy and radiation therapy could be used to treat CCSK in older patients.
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Affiliation(s)
- Yuxi Zhang
- Department of Urology, The First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang, 110001, China.
| | - Jun Li
- Department of Urology, The First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang, 110001, China
| | - Yan Wang
- Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, No. 155 Nanjing North Street, Shenyang, 110001, China
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Abstract
Clear cell sarcoma of the kidney is the second most common primary renal malignancy in childhood. It is histologically diverse, making accurate diagnosis challenging in some cases. Recent molecular studies have uncovered BCOR exon 15 internal tandem duplications in most cases, and YWHAE-NUTM2 fusion in a few cases, with the remaining cases having other genetic mutations, including BCOR-CCNB3 fusion and EGFR mutations. Although clear cell sarcoma of the kidney has no specific immunophenotype, several markers including cyclin D1, nerve growth factor receptor, and BCOR (BCL6 corepressor) have emerged as potential diagnostic aides. This review provides a concise account of recent advances in our understanding of clear cell sarcoma of the kidney to serve as a practical update for the practicing pathologist.
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Affiliation(s)
- Sze Jet Aw
- From the Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Republic of Singapore
| | - Kenneth Tou En Chang
- From the Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Republic of Singapore
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Muyi MMD, Bei XMD, Weiling CMD, Jianming SMD. Ultrasonic Imaging of Clear Cell Sarcoma of Kidney: A Case Report. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2019. [DOI: 10.37015/audt.2019.190803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Das I, Das RN, Dalal BS, Bisht J, Kanjilal B, Chatterjee U. FNAC aided diagnosis of clear cell sarcoma of kidney: Report of two cases in infants. Diagn Cytopathol 2017; 45:761-765. [DOI: 10.1002/dc.23728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/24/2017] [Accepted: 03/30/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Indranil Das
- Department of Pathology; NRS Medical College; Kolkata India
| | | | | | - Janki Bisht
- Department of Pediatric Surgery; IPGME&R; Kolkata India
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Zekri W, Alfaar AS, Yehia D, Elshafie MM, Zaghloul MS, El-Kinaai N, Taha H, Refaat A, Younes AA. Clear cell sarcoma of the kidney: patients' characteristics and improved outcome in developing countries. Pediatr Blood Cancer 2014; 61:2185-90. [PMID: 25175045 DOI: 10.1002/pbc.25192] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 06/27/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND Clear cell sarcoma of the kidney (CCSK) is a rare and aggressive tumor accounting for 5% of pediatric renal tumors with an incidence of 20 patients per year in the USA. It is bone metastasizing with poor prognosis. Our aim was to show characteristics of patients in relation to improved outcome in one of the developing countries. PROCEDURE We included all patients diagnosed as CCSK in the period between July 2007 and March 2012 at Children's Cancer Hospital, Egypt. Patients' demographics, clinical presentation, pathology, and management were reviewed. Follow up was continued until April 2013. RESULTS Twenty-five patients were identified in the defined time interval, accounting for 7% all renal tumors diagnosed at the hospital. Mean age was 36 months. Abdominal swelling and hematuria were the most common presentations. Stages I, II, III, IV, and V represented 9 (36%), 3 (12%), 8 (32%), 3 (12%), and 2 (8%), respectively. Twenty-four patients had radical nephrectomy either upfront or after neo-adjuvant chemotherapy. Surgery was followed by adjuvant chemotherapy. Abdominal radiotherapy was given for local stages II and III. Twenty-two patients reached complete remission, while one patient had stationary disease and two patients died due to progression and relapse. Overall survival was 88.5% and event-free survival was 87.8% at 45 months. CONCLUSION Although previous studies indicate poor prognosis of CCSK, our experience shows that those patients can be treated using extensive chemotherapy combined with proper local control.
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Affiliation(s)
- Wael Zekri
- Pediatric Oncology Department, Children's Cancer Hospital Egypt, Cairo, Egypt
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Gooskens SLM, Furtwängler R, Vujanic GM, Dome JS, Graf N, van den Heuvel-Eibrink MM. Clear cell sarcoma of the kidney: a review. Eur J Cancer 2012; 48:2219-26. [PMID: 22579455 DOI: 10.1016/j.ejca.2012.04.009] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 03/29/2012] [Accepted: 04/16/2012] [Indexed: 02/07/2023]
Abstract
Clear cell sarcoma of the kidney (CCSK) is a rare renal tumour that is observed most often in children under 3years of age. Only a few large series of CCSK have been reported and patients with CCSK are often included among patients with other types of childhood renal tumours. The purpose of this paper is to review the published series and case reports of CCSK and to create an up-to-date overview of clinical and histological features, genetics, treatment, and outcome.
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Affiliation(s)
- S L M Gooskens
- Department of Pediatric Hematology and Oncology, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands
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Sugandhi N, Munghate G, Malankar DP, Das S, Bisoi AK, Gupta AK, Agarwala S. Pediatric clear cell sarcoma of the kidney with cavoatrial thrombus. J Pediatr Surg 2011; 46:2387-90. [PMID: 22152888 DOI: 10.1016/j.jpedsurg.2011.09.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 09/09/2011] [Accepted: 09/09/2011] [Indexed: 10/14/2022]
Abstract
Clear cell sarcoma of the kidney (CCSK) is a rare renal tumor. Only 4 cases of CCSK with vascular thrombus have been reported, and 2 of these were pediatric cases. One of the children had an intraatrial thrombus as well. We describe a 3-year-old boy who was diagnosed as having a Wilms tumor but did not respond to preresection chemotherapy. He underwent complete resection of the tumor under cardiopulmonary bypass. Histologic examination indicated that the tumor was a CCSK. The patient was then managed with appropriate chemotherapy and radiation therapy and is well 16 months after diagnosis.
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Affiliation(s)
- Nidhi Sugandhi
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
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Nayak A, Iyer VK, Agarwala S. The cytomorphologic spectrum of Wilms tumour on fine needle aspiration: a single institutional experience of 110 cases. Cytopathology 2011; 22:50-9. [DOI: 10.1111/j.1365-2303.2010.00741.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hadley GP, Sheik-Gafoor MH. Clear cell sarcoma of the kidney in children: experience in a developing country. Pediatr Surg Int 2010; 26:345-8. [PMID: 20127337 DOI: 10.1007/s00383-010-2554-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/14/2010] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Clear cell sarcoma of the kidney (CCSK) is a rare tumour comprising 4% of primary renal tumours in children. It has a unique constellation of chromosomal and molecular features and should no longer be viewed as an unfavourable histological variant of Wilms tumour. Little is known of its clinical presentation and pathological profile in children living in a developing country. AIM To describe the clinical and pathological features of CCSK in children in our practice and to identify factors contributing to poor patient outcomes. METHOD A retrospective review of patients with a confirmed diagnosis of CCSK who presented for treatment at a single institution between 1990 and 2008. RESULTS 14 patients fulfilled the inception criteria. They represented 4% of 356 patients presenting with primary renal tumours during the review period. Clinical and radiological features were indistinguishable from Wilms tumour. Tumours were large (Mean mass 1.4 kg; median 0.9 kg) and metastases were common (42%). Lung and lymph node metastases were more common than skeletal disease. Co-morbidity, particularly hypertension (64%) was common. Initial diagnosis by needle biopsy was correct in only two of seven patients (29%) leading to inappropriate neoadjuvant chemotherapy. Overall survival is poor with 57% of patients alive and disease free from 1 to 7 years off treatment. CONCLUSION In a developing country, CCSK is rare and clinically and radiologically indistinguishable from Wilms tumour. Associated hypertension is common. Pretreatment diagnosis is difficult and sampling errors using needle biopsies may be unavoidable. Treatment results are poor and, given the propensity for late recurrence in CCSK, may not be sustained.
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Affiliation(s)
- G P Hadley
- Department of Paediatric Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Congella, South Africa.
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Cochand-Priollet B. Kidney and retroperitoneal tissues. Diagn Cytopathol 2010. [DOI: 10.1016/b978-0-7020-3154-0.00011-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Suciu V, Fabre M, Klijanienko J, Pohar-Marinsek Z, Vielh P. Childhood tumours. Diagn Cytopathol 2010. [DOI: 10.1016/b978-0-7020-3154-0.00033-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Taguchi K, Okada A, Kamiya H, Yamada Y, Tozawa K, Kohri K. Clear Cell Sarcoma of the Kidney: A Case Report of an 11-year-old Boy and A Review of 11 Cases in Japan. J Rural Med 2008. [DOI: 10.2185/jrm.3.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Ahmed HU, Arya M, Levitt G, Duffy PG, Mushtaq I, Sebire NJ. Part I: Primary malignant non-Wilms' renal tumours in children. Lancet Oncol 2007; 8:730-7. [PMID: 17679083 DOI: 10.1016/s1470-2045(07)70241-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Non-Wilms' tumours form a small heterogeneous group of clinically significant renal malignancies in children, including renal-cell carcinoma, clear-cell sarcoma, (congenital) mesoblastic nephroma, rhabdoid tumour, and renal medullary carcinoma. Good progress has been made in the assessment of these tumours, which has led to a greater understanding of the molecular changes that occur in their development. This review is the first of two parts, and provides an updated review of the clinical presentation, imaging, and pathology of these tumours.
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Affiliation(s)
- Hashim Uddin Ahmed
- Institute of Urology and Nephrology, University College London Hospitals NHS Foundation Trust, London, UK.
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