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Kang H, Xu W, Chang S, Yuan J, Bai X, Zhang J, Guo H, Ye H, Wang H. Mucinous tubular and spindle cell carcinomas of the kidney (MTSCC-Ks): CT and MR imaging characteristics. Jpn J Radiol 2022; 40:1175-1185. [PMID: 35644814 DOI: 10.1007/s11604-022-01294-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 05/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To strengthen the recognition of mucinous tubular and spindle cell carcinomas of the kidney (MTSCC-Ks) by analyzing CT and MR imaging findings of MTSCC-Ks. MATERIALS AND METHODS This study retrospectively enrolled ten patients with pathologically confirmed MTSCC-Ks from 2007 to 2020. The main observed imaging characteristics included growth pattern, signal characteristics on T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI), hemorrhage, necrosis, cystic degeneration, lipid component, pseudocapsule and the enhancement pattern. Apparent diffusion coefficient (ADC) value of MTSCC-Ks and normal renal cortex were measured, respectively. All imaging features were evaluated in consensus by two genitourinary radiologists. RESULTS All patients (53.1 ± 6.5 years, male to female, 3:7) presented with a solitary renal tumor with the mean diameter of 3.5 ± 0.4 cm. All lesions showed iso- or slight hypoattenuation on non-contrast CT with no hemorrhage but cystic degeneration (10%) and necrosis (10%). On T2WI, all lesions showed predominantly slight hypointensity with focal hyperintensity. The ADC value of MTSCC-Ks was 0.845 ± 0.017 × 10-3 mm2/s, and ADCtumor-to-ADCrenal cortex value was 0.376 ± 0.084. Pseudocapsules existed in all MTSCC-Ks on MRI. There were seven lesions showed heterogeneous enhancement, while three lesions showed homogeneous enhancement. Among them, six MTSCC-Ks showed slight multiple patchy enhancement (60%) in the corticomedullary phase, while the remaining MTSCC-Ks showed homogeneously slight enhancement (30%) or slightly stratified enhancement (10%). All MTSCC-Ks exhibited slow and progressive enhancement in the late phases. CONCLUSION Iso- or slight hypoattenuation on CT, slight hypointensity with focal hyperintensity on T2WI, marked diffusion restriction on DWI and ADC map, slight multiple patchy enhancement in the corticomedullary phase, and slow and progressive enhancement in the late phases are the imaging features of MTSCC-Ks, which may facilitate the diagnosis of MTSCC-Ks.
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Affiliation(s)
- Huanhuan Kang
- Medical School of Chinese PLA, Beijing, 100853, China.,Department of Radiology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Wei Xu
- Department of Radiology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Shuxiang Chang
- Department of Radiology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Jing Yuan
- Department of Pathology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Xu Bai
- Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Jing Zhang
- Department of Radiology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Huiping Guo
- Department of Radiology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Huiyi Ye
- Department of Radiology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Haiyi Wang
- Department of Radiology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
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New developments in existing WHO entities and evolving molecular concepts: The Genitourinary Pathology Society (GUPS) update on renal neoplasia. Mod Pathol 2021; 34:1392-1424. [PMID: 33664427 DOI: 10.1038/s41379-021-00779-w] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/11/2021] [Accepted: 02/11/2021] [Indexed: 12/28/2022]
Abstract
The Genitourinary Pathology Society (GUPS) reviewed recent advances in renal neoplasia, particularly post-2016 World Health Organization (WHO) classification, to provide an update on existing entities, including diagnostic criteria, molecular correlates, and updated nomenclature. Key prognostic features for clear cell renal cell carcinoma (RCC) remain WHO/ISUP grade, AJCC/pTNM stage, coagulative necrosis, and rhabdoid and sarcomatoid differentiation. Accrual of subclonal genetic alterations in clear cell RCC including SETD2, PBRM1, BAP1, loss of chromosome 14q and 9p are associated with variable prognosis, patterns of metastasis, and vulnerability to therapies. Recent National Comprehensive Cancer Network (NCCN) guidelines increasingly adopt immunotherapeutic agents in advanced RCC, including RCC with rhabdoid and sarcomatoid changes. Papillary RCC subtyping is no longer recommended, as WHO/ISUP grade and tumor architecture better predict outcome. New papillary RCC variants/patterns include biphasic, solid, Warthin-like, and papillary renal neoplasm with reverse polarity. For tumors with 'borderline' features between oncocytoma and chromophobe RCC, a term "oncocytic renal neoplasm of low malignant potential, not further classified" is proposed. Clear cell papillary RCC may warrant reclassification as a tumor of low malignant potential. Tubulocystic RCC should only be diagnosed when morphologically pure. MiTF family translocation RCCs exhibit varied morphologic patterns and fusion partners. TFEB-amplified RCC occurs in older patients and is associated with more aggressive behavior. Acquired cystic disease (ACD) RCC-like cysts are likely precursors of ACD-RCC. The diagnosis of renal medullary carcinoma requires a negative SMARCB1 (INI-1) expression and sickle cell trait/disease. Mucinous tubular and spindle cell carcinoma (MTSCC) can be distinguished from papillary RCC with overlapping morphology by losses of chromosomes 1, 4, 6, 8, 9, 13, 14, 15, and 22. MTSCC with adverse histologic features shows frequent CDKN2A/2B (9p) deletions. BRAF mutations unify the metanephric family of tumors. The term "fumarate hydratase deficient RCC" ("FH-deficient RCC") is preferred over "hereditary leiomyomatosis and RCC syndrome-associated RCC". A low threshold for FH, 2SC, and SDHB immunohistochemistry is recommended in difficult to classify RCCs, particularly those with eosinophilic morphology, occurring in younger patients. Current evidence does not support existence of a unique tumor subtype occurring after chemotherapy/radiation in early childhood.
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Yang C, Cimera RS, Aryeequaye R, Jayakumaran G, Sarungbam J, Al-Ahmadie HA, Gopalan A, Sirintrapun SJ, Fine SW, Tickoo SK, Epstein JI, Reuter VE, Zhang Y, Chen YB. Adverse histology, homozygous loss of CDKN2A/B, and complex genomic alterations in locally advanced/metastatic renal mucinous tubular and spindle cell carcinoma. Mod Pathol 2021; 34:445-456. [PMID: 32879414 PMCID: PMC7855055 DOI: 10.1038/s41379-020-00667-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/17/2020] [Accepted: 08/20/2020] [Indexed: 12/29/2022]
Abstract
Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare subtype of renal cell carcinoma with characteristic histologic features and chromosomal alterations. Although typically indolent, a small subset of cases has been reported to exhibit aggressive clinical behavior. We retrospectively identified 33 patients with MTSCC, consisting of 10 cases of locally advanced/metastatic MTSCC (pT3 or N1 or M1) and 23 kidney-confined MTSCC (pT1/T2) without disease recurrence or progression. Utilizing a single-nucleotide polymorphism array and a targeted next-generation sequencing platform, we examined genome-wide molecular alterations in 24 cases, including 11 available samples from 8 patients with locally advanced/metastatic MTSCC. Ten patients with locally advanced/metastatic MTSCC were 8 females (80%) and 2 males (20%). At nephrectomy, 7 of these 10 cases (70%) were pT3 or pN1 while the remaining 3 (30%) were pT1/T2. Eight patients (80%) developed metastases and common sites included lymph node (4, 40%), bone (4, 40%), and retroperitoneum (3, 30%). Four patients died of disease (40%) during follow-up. Locally advanced/metastatic MTSCCs shared typical MTSCC genomic profiles with loss of chromosomes 1, 4, 6, 8, 9, 13, 14, 15, and 22, while some exhibited additional complex genomic alterations, most frequently a relative gain of 1q (7/8). Homozygous loss of CDKN2A/B was observed in 3 (38%) locally advanced/metastatic MTSCCs. Tumor necrosis, solid nested/sheet pattern, irregular trabecular/single-file infiltration in a desmoplastic stroma, lymphovascular space invasion, and increased mitotic activity were associated with locally advanced/metastatic MTSCCs (all p < 0.05). Our findings reveal that MTSCCs with aggressive clinical behavior have progressed through clonal evolution; CDKN2A/B deletion and additional complex genomic abnormalities may contribute to this process. Recognizing the morphologic presentation of high-grade MTSCC and evaluating adverse histologic features seen in these tumors can help establish a definitive diagnosis and stratify patients for treatment and prognostication.
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Affiliation(s)
- Chen Yang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Robert S Cimera
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Ruth Aryeequaye
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Gowtham Jayakumaran
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Judy Sarungbam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Hikmat A Al-Ahmadie
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Anuradha Gopalan
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - S Joseph Sirintrapun
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Samson W Fine
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Satish K Tickoo
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Jonathan I Epstein
- Departments of Pathology, Urology, and Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
| | - Victor E Reuter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Yanming Zhang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Ying-Bei Chen
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
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Miura K, Adachi Y, Shirahase T, Nagashima Y, Suemune K, Sakaida N, Nakano Y, Sakai Y, Shimizu S, Ikehara S. A case of high-grade mucinous tubular and spindle cell carcinoma. J Surg Case Rep 2020; 2020:rjaa014. [PMID: 32104563 PMCID: PMC7033487 DOI: 10.1093/jscr/rjaa014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 02/06/2020] [Indexed: 01/31/2023] Open
Abstract
Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare renal cell carcinoma that initially presents as low-grade renal cell carcinoma. However, cases of MTSCC with high-grade histology and poor prognosis have been reported. Here, we report a case of MTSCC with high-grade histological features and metastasis. A 77-year-old woman consulted a hospital following frequent and painful micturition. Computed tomography scan revealed a tumor of the left kidney. First, chemotherapy was performed, with no effects. Therefore, nephrectomy was subsequently performed. Histologically, the tumor showed the features of MTSCC with sarcomatoid component. Metastasis of the tumor into the lymph node was also observed. Although adjuvant chemotherapy was performed after nephrectomy, metastasis to the lungs and bone and local recurrence was observed. The patient is still alive 2 years after nephrectomy with metastasis and recurrence of the tumor. High-grade MTSCC shows a relatively poor prognosis, specifically MTSCC with metastasis upon nephrectomy.
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Affiliation(s)
- Koujin Miura
- Resident, Toyooka Hospital, Toyooka, Hyogo, Japan
| | - Yasushi Adachi
- Department of Diagnostic Pathology, Toyooka Hospital, Toyooka, Hyogo, Japan
| | | | - Yoji Nagashima
- Department of Surgical Pathology, Tokyo Women's Medical University Tokyo, Tokyo, Japan
| | | | - Noriko Sakaida
- Department of Pathology and Cytology Center, BML Group PCL Japan, Ibaraki, Osaka, Japan.,Department of Pathology, Osaka City University Graduate School of Medicine, Osaka, Osaka, Japan
| | - Yorika Nakano
- Department of Histopathology and Cytology, Japanese Red Cross Kyoto Daini Hospital, Kyoto City, Kyoto, Kyoto, Japan
| | - Yasuhiro Sakai
- Department of Diagnostic Pathology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Shigeki Shimizu
- Department of Pathology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - Susumu Ikehara
- Department of Stem Cell Disorders, Kansai Medical University, Hirakata, Osaka, Japan
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Distinct Genomic Copy Number Alterations Distinguish Mucinous Tubular and Spindle Cell Carcinoma of the Kidney From Papillary Renal Cell Carcinoma With Overlapping Histologic Features. Am J Surg Pathol 2019; 42:767-777. [PMID: 29462091 DOI: 10.1097/pas.0000000000001038] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney is a rare type of renal cell carcinoma that frequently exhibits histologic and immunophenotypic features overlapping with type 1 papillary renal cell carcinoma (PRCC). To clarify molecular attributes that can be used for this difficult differential diagnosis, we sought to delineate the genome-wide copy number alterations in tumors displaying classic histologic features of MTSCC in comparison to the solid variant of type 1 PRCC and indeterminate cases with overlapping histologic features. The study included 11 histologically typical MTSCC, 9 tumors with overlapping features between MTSCC and PRCC, and 6 cases of solid variant of type 1 PRCC. DNA samples extracted from macrodissected or microdissected tumor areas were analyzed for genome-wide copy number alterations using an SNP-array platform suitable for clinical archival material. All cases in the MTSCC group exhibited multiple chromosomal losses, most frequently involving chromosomes 1, 4, 6, 8, 9, 13, 14, 15, and 22, while lacking trisomy 7 or 17. In contrast, cases with overlapping morphologic features of MTSCC and PRCC predominantly showed multiple chromosomal gains, most frequently involving chromosomes 7, 16, 17, and 20, similar to the chromosomal alteration pattern that was seen in the solid variant of type 1 PRCC cases. Morphologic comparison of these molecularly characterized tumors identified histologic features that help to distinguish MTSCC from PRCC, but immunohistochemical profiles of these tumors remained overlapping, including a marker for Hippo-Yes-associated protein signaling. Characteristic patterns of genome-wide copy number alterations strongly support MTSCC and PRCC as distinct entities despite their immunohistochemical and certain morphologic overlap, and help define histologic features useful for the classification of questionable cases.
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Hatayama T, Sekino Y, Shikuma H, Mukai S, Muto M, Miyamoto S, Sadahide K, Fukuoka K, Fuji S, Goto K, Shinmei S, Hieda K, Inoue S, Hayashi T, Teishima J, Kuroda N, Sentani K, Yasui W, Matsubara A. Case of renal mucinous tubular and spindle cell carcinoma with high nuclear grade. IJU Case Rep 2019; 2:193-196. [PMID: 32743410 PMCID: PMC7292185 DOI: 10.1002/iju5.12075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 04/10/2019] [Indexed: 11/18/2022] Open
Abstract
Introduction Renal mucinous tubular and spindle cell carcinoma is a rare subtype of renal cell carcinoma newly added to the World Health Organization classification in 2004. Although it has been considered as a tumor with good prognosis, aggressive cases have recently been reported. Case presentation A 52‐year‐old man was diagnosed as having left renal cell carcinoma. Open radical left nephrectomy and left‐sided pelvic lymph nodes dissection were performed. Pathological diagnosis revealed a renal mucinous tubular and spindle cell carcinoma with high nuclear grade and extra‐regional lymph nodes metastasis classified as pT3aN0M1. After nephrectomy, metastasis at second lumbar vertebra and lymph nodes recurrence were occurred. Conclusion This tumor with high nuclear grade may be potentially aggressive and carries a poor prognosis.
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Affiliation(s)
- Tomoya Hatayama
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Yohei Sekino
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hiroyuki Shikuma
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Sakurako Mukai
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Masayuki Muto
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Shunsuke Miyamoto
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Kosuke Sadahide
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Kenichiro Fukuoka
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Shinsuke Fuji
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Keisuke Goto
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Shunsuke Shinmei
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Keisuke Hieda
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Shogo Inoue
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Tetsutaro Hayashi
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Jun Teishima
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Naoto Kuroda
- Department of Diagnostic PathologyKochi Red Cross HospitalKochiJapan
| | - Kazuhiro Sentani
- Department of Molecular PathologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Wataru Yasui
- Department of Molecular PathologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Akio Matsubara
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
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Sakatani T, Okumura Y, Kuroda N, Magaribuchi T, Nakano Y, Shirahase T, Watanabe J, Taki Y, Okigaki M, Ikehara S, Adachi Y. Mucinous tubular and spindle cell carcinoma with a high nuclear grade and micropapillary pattern: A case report. Mol Clin Oncol 2017; 7:976-980. [PMID: 29285359 PMCID: PMC5740859 DOI: 10.3892/mco.2017.1430] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 07/04/2017] [Indexed: 01/04/2023] Open
Abstract
Mucinous tubular and spindle cell carcinoma (MTSCC) is rare in renal cell carcinoma (RCC) and usually demonstrates a low nuclear grade and a better prognosis compared with other RCCs. The authors present a case report of MTSCC containing an area of Fuhrman nuclear grade 3, in addition to an area with a micropapillary pattern. An 82-year-old man consulted a hospital due to macrohematuria, and a tumor in the right kidney was detected. The tumor was resected and histologically examined. The tumor consisted of various growth patterns: Elongated tubular structure, a papillary structure containing a micropapillary pattern and solid pattern with spindle cells. The tumor cells demonstrated Fuhrman nuclear grades 2 and 3. Invasion into the lymph vessel and metastasis into the regional lymph node were observed. Thus, the tumor was diagnosed as a high grade MTSCC. Five months following resection, a computed tomography scan suggested metastasis of the tumor into the para-aortic lymph nodes and liver, and the patient succumbed to brain metastasis. When MTSCC of kidney is observed, careful histological observation is important to avoid missing a high nuclear grade area.
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Affiliation(s)
- Toru Sakatani
- Department of Urology, Toyooka Hospital, Toyooka, Hyogo 668-8501, Japan
| | - Yoshinaga Okumura
- Department of Urology, Toyooka Hospital, Toyooka, Hyogo 668-8501, Japan
| | - Naoto Kuroda
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi 780-8562, Japan
| | | | - Yorika Nakano
- Department of Histopathology and Cytology, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602-8026, Japan
| | | | - Jun Watanabe
- Department of Urology, Toyooka Hospital, Toyooka, Hyogo 668-8501, Japan
| | - Yoji Taki
- Department of Urology, Toyooka Hospital, Toyooka, Hyogo 668-8501, Japan
| | - Mitsuhiko Okigaki
- Department of Internal Medicine, Otokoyama Hospital, Yawata, Kyoto 614-8366, Japan
| | - Susumu Ikehara
- Professor Emeritus, Kansai Medical University, Hirakata, Osaka 573-1010, Japan
| | - Yasushi Adachi
- Department of Diagnostic Pathology, Toyooka Hospital, Toyooka, Hyogo 668-8501, Japan
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Zhao M, He XL, Teng XD. Mucinous tubular and spindle cell renal cell carcinoma: a review of clinicopathologic aspects. Diagn Pathol 2015; 10:168. [PMID: 26377921 PMCID: PMC4573286 DOI: 10.1186/s13000-015-0402-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 08/28/2015] [Indexed: 02/03/2023] Open
Abstract
Mucinous tubular and spindle cell renal cell carcinoma is a rare, recently described variant of renal cell carcinoma characterized by an admixture of cuboidal cells in tubules and sheets of spindle cells, and variable amounts of mucinous stroma. It has been recognized as a distinct entity in the 2004 World Health Organization tumor classification. Since then, several dozen of these tumor have been reported with additional complementary morphologic characteristics, immunohistochemical profile, and molecular genetic features that have further clarified its clinicopathologic aspects. Although originally considered as a low grade renal cell carcinoma on the basis of its bland appearing nuclear features and indolent clinical course, mucinous tubular and spindle cell renal cell carcinoma has currently been proven to be a tumor that has a histological spectrum ranging from low to high grade that includes sarcomatoid differentiation. In this review, we present a detailed summary of the current knowledge regarding the clinicopathologic, immunohistochemical, molecular genetic, and prognostic characteristics, as well as differential diagnoses of mucinous tubular and spindle cell renal cell carcinoma.
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Affiliation(s)
- Ming Zhao
- Depatment of Pathology, Zhejiang Provincial People's Hospital, Hangzhou, 310014, China.
| | - Xiang-Lei He
- Depatment of Pathology, Zhejiang Provincial People's Hospital, Hangzhou, 310014, China.
| | - Xiao-Dong Teng
- Department of Pathology, The First Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, 310003, China.
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