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Grosse A, Grosse C. Fine needle aspiration biopsy of mucinous tubular and spindle cell carcinoma. Cytopathology 2019; 31:78-80. [PMID: 31347198 DOI: 10.1111/cyt.12748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/15/2019] [Accepted: 06/20/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Alexandra Grosse
- Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - Claudia Grosse
- Institute of Pathology, Kepler University Hospital, Linz, Austria
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Huimiao J, Chepovetsky J, Zhou M, Sun W, Simsir A, Cohen D, Leung A. Mucinous tubular and spindle cell carcinoma of the kidney: Diagnosis by fine needle aspiration and review of the literature. Cytojournal 2016; 12:28. [PMID: 26884801 PMCID: PMC4730794 DOI: 10.4103/1742-6413.171135] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 08/28/2015] [Indexed: 11/04/2022] Open
Abstract
Renal mucinous tubular and spindle cell carcinoma (MTSCC) was recently described as a distinct subtype of renal cell carcinoma (RCC) in the 2004 World Health Organization classification of kidney tumors. MTSCC is a rare low grade malignancy with < 100 cases reported in the literature. To the best of our knowledge, there are 5 case reports with a total of 6 patients describing its diagnosis by fine needle aspiration (FNA). All of these cases were diagnosed as conventional RCC on FNA. Subsequent excisions proved them to be MTSCC. We herein report a case in a 67-year-old male. He presented with abdominal pain and was found to have a new colon adenocarcinoma with metastasis to the liver and lungs. The extent of disease made the patient ineligible for surgical excision, and he received chemotherapy. Work-up also revealed a kidney mass which was later biopsied by FNA and core biopsy. The tumor was composed of epithelial and spindled cell components embedded in a myxoid background. It was positive for CK7, AMCAR, vimentin, and epithelial membrane antigen. The tumor was diagnosed as MTSCC. One year later the kidney mass remained stable. However, the patient developed new metastasis to the liver from colonic primary. The kidney mass was not resected. Although rarely encountered in FNA cytology of the kidney, we believe the cytologic features of this tumor are distinctive and are different from conventional and other subtypes of RCC. Therefore, its accurate diagnosis on FNA is possible once pathologists are aware that MTSCC should be considered in the differential diagnosis of kidney tumors.
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Affiliation(s)
- Jiang Huimiao
- Address: Department of Pathology, NYU Langone Medical Center, New York, NY 10016, USA
| | - Julie Chepovetsky
- Address: Department of Pathology, NYU Langone Medical Center, New York, NY 10016, USA
| | - Ming Zhou
- Address: Department of Pathology, NYU Langone Medical Center, New York, NY 10016, USA
| | - Wei Sun
- Address: Department of Pathology, NYU Langone Medical Center, New York, NY 10016, USA
| | - Aylin Simsir
- Address: Department of Pathology, NYU Langone Medical Center, New York, NY 10016, USA
| | - Deirdre Cohen
- Department of Medical Oncology, NYU Langone Medical Center, New York, NY 10016, USA
| | - Allen Leung
- Address: Department of Pathology, NYU Langone Medical Center, New York, NY 10016, USA
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Marks-Jones DA, Zynger DL, Parwani AV, Cai G. Fine needle aspiration biopsy of renal mucinous tubular and spindle cell carcinoma: report of two cases. Diagn Cytopathol 2009; 38:51-5. [PMID: 19626627 DOI: 10.1002/dc.21151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare renal tumor. Here we report two cases of MTSCC which were initially evaluated by fine needle aspiration biopsy (FNAB) and followed by surgical resection of the tumors. The cytomorphologic features of MTSCC were characterized by aggregates of relatively uniform, predominantly oval to spindle cells intermixed with abundant metachromatic myxoid matrix. Only rare epithelioid tumor cells with vacuolated cytoplasm were present. Immunohistochemically, the tumor cells were positive for CK7, CK19, CD10, vimentin, E-cadherin, alpha-methyl CoA racemase, and negative for CK903 and CK20. EMA and carbonic anhydrase IX immunoreactivity was seen in one of the two cases. Multiple chromosomal losses involving chromosomes 1, 2, 17 and likely chromosome 7 were revealed by fluorescence in situ hybridization (FISH). These cytomorphologic, immunophenotypic, and cytogenetic features were helpful for including this entity in the differential diagnosis of renal cell carcinomas.
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Affiliation(s)
- Deborah A Marks-Jones
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Won KY, Kim GY, Lim SJ, Kim HC, Jeon SH. Mucinous Tubular and Spindle Cell Carcinoma of the Kidney: Touch Imprint Cytologic and Histologic Findings - A Case Report -. ACTA ACUST UNITED AC 2008. [DOI: 10.3338/kjc.2008.19.2.194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Kyu-Yeoun Won
- Department of Pathology, East-West Neo Medical center, School of Medicine, Kyunghee University, Seoul, Korea
| | - Gou Young Kim
- Department of Pathology, East-West Neo Medical center, School of Medicine, Kyunghee University, Seoul, Korea
| | - Sung-Jig Lim
- Department of Pathology, East-West Neo Medical center, School of Medicine, Kyunghee University, Seoul, Korea
| | - Hyun Cheol Kim
- Department of Radiology, East-West Neo Medical center, School of Medicine, Kyunghee University, Seoul, Korea
| | - Seung Hyun Jeon
- Department of Urology, East-West Neo Medical center, School of Medicine, Kyunghee University, Seoul, Korea
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Owens CL, Argani P, Ali SZ. Mucinous tubular and spindle cell carcinoma of the kidney: cytopathologic findings. Diagn Cytopathol 2007; 35:593-6. [PMID: 17703454 DOI: 10.1002/dc.20688] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A 54-year-old woman was hospitalized for flank pain and acute renal failure when imaging studies revealed a 5.2 cm mass in the left kidney. She was referred for fine needle aspiration of the lesion, which showed an epithelial tumor with round to oval nuclei associated with strands of metachromatic stromal tissue. Cytopathologic diagnosis was consistent with renal cell carcinoma. Subsequent nephrectomy was performed and the surgical pathology specimen showed a mucinous tubular and spindle cell carcinoma of the kidney. The patient has done well post-operatively with 10 months of benign follow-up.
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Affiliation(s)
- Christopher L Owens
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA
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Shen SS, Truong LD, Ayala AG, Ro JY. Recently Described and Emphasized Entities of Renal Neoplasms. Arch Pathol Lab Med 2007; 131:1234-43. [PMID: 17683186 DOI: 10.5858/2007-131-1234-rdaeeo] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2006] [Indexed: 11/06/2022]
Abstract
Abstract
Context.—Recent advances of molecular biology and cytogenetics of renal cancer have resulted in the new classification of renal neoplasms and a number of subtypes are identified and emphasized. In addition, rare nonepithelial renal neoplasms are identified and characterized. Familiarity with these entities will help make the most accurate diagnosis and guide the treatment and follow-up of patients with renal neoplasm.
Objective.—To review the clinicopathologic entities of renal neoplasms that are recently defined or emphasized. Their clinical, gross, microscopic, and immunohistochemical features, as well as specific cytogenetic or molecular abnormalities, are discussed. Important differential diagnoses of each entity are also briefly discussed.
Data Sources.—Extensive review of published literature and our experience.
Conclusions.—A number of new entities of renal neoplasms or genetically defined renal cell carcinomas have been identified or emphasized because of their unique genetic or molecular changes. Recognition of these entities becomes important as some of them have different biologic behavior and treatment strategies may be different.
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Affiliation(s)
- Steven S Shen
- Department of Pathology, The Methodist Hospital, 6565 Fannin St, Houston, TX 77030, USA.
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Pacchioni D, Volante M, Casetta G, Sapino A, Marchiò C, Bussolati G. Myxoid renal tumor with myoepithelial differentiation mimicking a salivary gland pleomorphic adenoma: description of a case. Am J Surg Pathol 2007; 31:632-6. [PMID: 17414112 DOI: 10.1097/01.pas.0000213446.16526.36] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We herein report an unusual case of a low-grade myxoid renal epithelial neoplasm, with peculiar and previously unreported morphologic and immunohistochemical features. The lesion was characterized by noninfiltrative borders, myxoid stroma and elongated tubular and cordlike epithelial structures. These were lined by 2 different epithelial cell types, flat and elongated basal cells and cuboidal to spindle shaped eosinophilic luminal cells, with low-grade nuclear features and a few small nucleoli. The lesion morphologically resembled a pleomorphic adenoma of the salivary gland. The immunohistochemical profile interestingly confirmed the myoepithelial differentiation of the basal epithelial layer, as demonstrated by the coexpression of several myoepithelial markers such as p63, caldesmon, calponin, smooth muscle actin, and S-100, together with epithelial markers such as low and high-molecular weight cytokeratins. The tumor proved benign at follow-up. A definitive classification and histogenetic interpretation of this previously unreported tumor type awaits description of further cases showing similar features which, perhaps, as it may happen, went so far unnoticed.
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Shen SS, Ro JY, Tamboli P, Truong LD, Zhai Q, Jung SJ, Tibbs RG, Ordonez NG, Ayala AG. Mucinous tubular and spindle cell carcinoma of kidney is probably a variant of papillary renal cell carcinoma with spindle cell features. Ann Diagn Pathol 2007; 11:13-21. [PMID: 17240302 DOI: 10.1016/j.anndiagpath.2006.09.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Mucinous tubular and spindle cell carcinoma is a rare and newly described type of renal cell carcinoma (RCC) with a relatively indolent behavior. However, its histogenetic origin or line of differentiation remains unclear. Twelve cases of mucinous tubular and spindle cell carcinoma were identified and retrieved from the files of 3 institutions. Detailed morphological features, as well as their immunohistochemical profile established with markers of proximal renal tubules (RCC marker antigen, CD15, and alpha-methylacyl-CoA racemase) and of distal renal tubules (kidney-specific cadherin and cytokeratin 7), were studied. The age range of the patients was 35 to 73 years with a median of 56 years. The male to female ratio was 1:3. All of the patients were alive with follow-up between 4 and 38 months. All the tumors were confined to the kidney with a mean tumor size of 6.9 cm (range, 1.8-17 cm). The tumors were composed of variable proportions of tubular and spindle cell areas with focal to prominent mucinous or myxoid stroma. Foamy macrophages were seen in 10 cases and were prominent in 4 cases. A focal compressed tubulopapillary growth pattern was seen in 10 cases. The tumor cells were uniformly cuboidal with ovoid to round nuclei and inconspicuous nucleoli (Furhman nuclear grade 3 in 6 cases). Focal necrosis was seen in 3 cases. Immunostains showed that tumors were positive for RCC marker antigen (11/12), alpha-methylacyl-CoA racemase (11/12), CD15 (8/12), CD10 (2/12), kidney-specific cadherin (1/12), and cytokeratin 7 (11/12). Its morphological features as well as a strong preferential expression of proximal tubule markers suggest that this tumor is a type of RCC with proximal tubular differentiation, which appears closely related to or represents a morphological variant of papillary RCC.
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Affiliation(s)
- Steven S Shen
- Department of Pathology, The Methodist Hospital and Research Institute, Houston, TX 77030, USA.
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