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Dobrijevic E, van Zwieten A, Grant AJ, Loy CT, Craig JC, Teixeira-Pinto A, Wong G. Causal Relationship Between Kidney Function and Cancer Risk: A Mendelian Randomization Study. Am J Kidney Dis 2024:S0272-6386(24)00895-3. [PMID: 39084486 DOI: 10.1053/j.ajkd.2024.05.016] [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: 02/07/2024] [Revised: 05/07/2024] [Accepted: 05/17/2024] [Indexed: 08/02/2024]
Abstract
RATIONALE & OBJECTIVE Patients treated with kidney replacement therapy experience a 1.5 to 2-fold increased risk of cancer and cancer mortality compared to the general population. Whether this excess risk extends to people with earlier stages of chronic kidney disease is unclear. This study explored the potentially causal relationship between reduced kidney function and cancer. STUDY DESIGN Two-sample Mendelian randomization (MR). SETTING & PARTICIPANTS Genome Wide Association Study (GWAS) summary statistics for estimated glomerular filtration rate (eGFR) (n=567,460) and urinary albuminuria (UACR) (n=127,865) from the CKDGen consortium and cancer outcomes from the UK Biobank (n=407,329). EXPOSURES eGFR and UACR. OUTCOMES Overall cancer incidence, cancer-related mortality, and site-specific colorectal, lung, and urinary tract cancer incidence. ANALYTICAL APPROACH Univariable and multivariable MR were conducted for all outcomes using inverse-variance weighted methods. RESULTS The mean eGFR and median UACR were 91.4 mL/min/1.73m2 and 9.32 mg/g in the CKDGen and 90.4 mL/min/1.73m2 and 9.29 mg/g in the UK Biobank. There were 98,093 cases of cancer, 6,664 colorectal, 3584 lung, and 3,271 urinary tract. There were 15,850 cases of cancer-related death, The genetic instruments for eGFR and UACR comprised 34 and 38 variants, respectively. Genetically predicted kidney function (eGFR and UACR) was not associated with overall cancer risk or cancer death. No associations of genetically predicted eGFR and UACR with overall cancer incidence were observed; odds ratio (95%CI; p-value) of 0.88 (0.40-1.97; p=0.76) and 0.90 (0.78-1.04; p=0.16), respectively. An adjusted generalized additive model for eGFR and cancer demonstrated evidence of non-linearity. There was no evidence of a causal association between eGFR and cancer in a stratified MR. LIMITATIONS To avoid overlapping samples a smaller GWAS for UACR was used, reducing the strength of the instrument and potentially introducing population stratification. CONCLUSIONS These findings did not demonstrate a causal association of kidney function with overall cancer incidence or cancer-related death.
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Affiliation(s)
- Ellen Dobrijevic
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia.
| | - Anita van Zwieten
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Andrew J Grant
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Clement T Loy
- Macquarie Medical School, Macquarie University, Sydney, NSW, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, SA, Australia
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Germaine Wong
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia; Centre for Transplant and Renal Research, Westmead Hospital, Westmead, NSW, Australia
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Palathingal Bava E, Sanfrancesco JM, Alkashash A, Favazza L, Aldilami A, Williamson SR, Cheng L, Idrees MT, Al-Obaidy KI. Acquired cystic disease associated renal cell carcinoma: A clinicopathologic and molecular study of 31 tumors. Hum Pathol 2024; 149:48-54. [PMID: 38862094 DOI: 10.1016/j.humpath.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/31/2024] [Accepted: 06/08/2024] [Indexed: 06/13/2024]
Abstract
Acquired cystic disease associated renal cell carcinomas (ACD-RCC) are rare and their molecular and histopathological characteristics are still being explored. We therefore investigated the clinicopathologic and molecular characteristics of 31 tumors. The patients were predominantly male (n = 30), with tumors mainly left-sided (n = 17), unifocal (n = 19), and unilateral (n = 29) and a mean tumor size of 25 mm (range, 3-65 mm). Microscopically, several histologic patterns were present, including pure classic sieve-like (n = 4), and varied proportions of mixed classic sieve-like with papillary (n = 23), tubulocystic (n = 9), compact tubular (n = 4) and solid (n = 1) patterns. Calcium-oxalate crystals were seen in all tumors. Molecular analysis of 9 tumors using next generation sequencing showed alterations in SMARCB1 in 3 tumors (1 with frameshift deletion and 2 with copy number loss in chromosome 22 involving SMARCB1 region), however, INI1 stain was retained in all. Nonrecurrent genetic alterations in SETD2, NF1, NOTCH4, BRCA2 and CANT1 genes were also seen. Additionally, MTOR p.Pro351Ser was identified in one tumor. Copy number analysis showed gains in chromosome 16 (n = 5), 17 (n = 2) and 8 (n = 2) as well as loss in chromosome 22 (n = 2). In summary, ACD-RCC is a recognized subtype of kidney tumors, with several histological architectural patterns. Our molecular data identifies genetic alterations in chromatin modifying genes (SMARCB1 and SETD2), which may suggest a role of such genes in ACD-RCC development.
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Affiliation(s)
- Ejas Palathingal Bava
- Department of Pathology and Laboratory Medicine, Henry Ford Health, Detroit, MI, USA.
| | | | - Ahmed Alkashash
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, USA.
| | - Laura Favazza
- Department of Pathology and Laboratory Medicine, Henry Ford Health, Detroit, MI, USA.
| | - Akram Aldilami
- Department of Neurology, Henry Ford Health, Detroit, MI, USA.
| | - Sean R Williamson
- Pathology and Laboratory Medicine Institute, The Cleveland Clinic, Cleveland, OH, USA.
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Mohammed T Idrees
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, USA.
| | - Khaleel I Al-Obaidy
- Department of Pathology and Laboratory Medicine, Henry Ford Health, Detroit, MI, USA; Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
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3
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Mansour H, Tran-Dang MA, Walkden M, Boleti E, Barod R, Patki P, Mumtaz F, Tran MGB, Bex A, El Sheikh S. Renal mass biopsy - a practical and clinicopathologically relevant approach to diagnosis. Nat Rev Urol 2024:10.1038/s41585-024-00897-5. [PMID: 38907039 DOI: 10.1038/s41585-024-00897-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2024] [Indexed: 06/23/2024]
Abstract
Advancements in imaging modalities have increased the frequency of renal mass discovery. Imaging has typically been considered sufficient to guide management for a large proportion of these tumours, but renal mass biopsies (RMBs) have an increasing role in determining malignancy and can be a valuable tool for preventing unnecessary surgery in patients with benign tumours. A structured approach should be used to help to navigate the expanding repertoire of renal tumours, many of which are molecularly defined. In terms of tumour subtyping, the pathologist's strategy should focus on stratifying patients into clinically different prognostic groups according to our current knowledge of tumour behaviour, including benign, low-grade or indolent, intermediate malignant or highly aggressive. Crucial pathological features and morphological mimicry of tumours can alter the tumour's prognostic group. Thus, pathologists and urologists can use RMB to select patients with tumours at a reduced risk of progression, which can be safely managed with active surveillance within a tailored imaging schedule, versus tumours for which ablation or surgical intervention is indicated. RMB is also crucial in the oncological setting to distinguish between different high-grade tumours and guide tailored management strategies.
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Affiliation(s)
- Hussein Mansour
- Research Department of Pathology, UCL Cancer Institute, London, UK
| | - My-Anh Tran-Dang
- Specialist centre for kidney cancer, Royal Free London Hospital, London, UK
| | - Miles Walkden
- Specialist centre for kidney cancer, Royal Free London Hospital, London, UK
- UCL Division of Surgery and Interventional Science, Rowland Street, London, UK
| | - Ekaterini Boleti
- Specialist centre for kidney cancer, Royal Free London Hospital, London, UK
| | - Ravi Barod
- Specialist centre for kidney cancer, Royal Free London Hospital, London, UK
- UCL Division of Surgery and Interventional Science, Rowland Street, London, UK
| | - Prasad Patki
- Specialist centre for kidney cancer, Royal Free London Hospital, London, UK
- UCL Division of Surgery and Interventional Science, Rowland Street, London, UK
| | - Faiz Mumtaz
- Specialist centre for kidney cancer, Royal Free London Hospital, London, UK
- UCL Division of Surgery and Interventional Science, Rowland Street, London, UK
| | - Maxine G B Tran
- Specialist centre for kidney cancer, Royal Free London Hospital, London, UK
- UCL Division of Surgery and Interventional Science, Rowland Street, London, UK
| | - Axel Bex
- Specialist centre for kidney cancer, Royal Free London Hospital, London, UK
- UCL Division of Surgery and Interventional Science, Rowland Street, London, UK
| | - Soha El Sheikh
- Research Department of Pathology, UCL Cancer Institute, London, UK.
- Specialist centre for kidney cancer, Royal Free London Hospital, London, UK.
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Sakai Y, Oikawa K, Matsukawa M. Collision tumor of spindle cell lipoma arising from perirenal tissue and acquired cystic disease-associated renal cell carcinoma: A rare case report. IJU Case Rep 2023; 6:314-317. [PMID: 37667768 PMCID: PMC10475343 DOI: 10.1002/iju5.12617] [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: 11/27/2022] [Accepted: 07/13/2023] [Indexed: 09/06/2023] Open
Abstract
Introduction Collision tumors are a rare phenomenon defined as two or more histologically distinct tumors that are in contact with each other. Case presentation The patient was a man with a history of end-stage diabetic nephropathy under hemodialysis treatment for 15 years. A plain computed tomography scan showed a 4.3 cm mass with obscured margins in the right perirenal fat of the lower pole kidney. On T2-weighted magnetic resonance imaging, the lesion showed heterogeneous signal intensity with a partially cystic component. A radical nephrectomy was performed. Histopathological and immunohistochemical examination revealed collision tumors constituted of a spindle cell lipoma covering the kidney surface underneath the perirenal fat and diffusely distributed acquired cystic disease-associated renal cell carcinoma in the renal parenchyma. Conclusion We report the first case of collision tumors comprising spindle cell lipoma and acquired cystic disease-associated renal cell carcinoma.
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Affiliation(s)
- Yasuyuki Sakai
- Department of UrologyTakikawa Municipal HospitalTakikawaHokkaidoJapan
- Present address:
Department of UrologySapporo Medical University School of MedicineSapporoHokkaidoJapan
| | - Kensuke Oikawa
- Division of Pathology, Department of NursingAsahikawa Medical University HospitalAsahikawaHokkaidoJapan
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Wang IK, Yu TM, Yen TH, Lin CL, Li CY, Hsu CM, Tsai TH, Sung FC. Comparison of the risks of renal cell carcinoma or urothelial cancer between hemodialysis and peritoneal dialysis patients. Int Urol Nephrol 2023; 55:2267-2274. [PMID: 36859625 DOI: 10.1007/s11255-023-03534-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/23/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE This study is to compare risks of developing renal cell carcinoma or urothelial cancer between hemodialysis (HD) and peritoneal dialysis (PD) patients. METHODS The age-, sex-, and index year-matched patients with newly diagnosed end-stage kidney disease (ESKD) undergoing dialysis [HD (N = 22,587) or PD (N = 11,547)] from 2000 to 2015 in Taiwan were identified. Patients were followed until the development of renal cell carcinoma or urothelial cancer, renal transplantation, death, or the end of follow-up (December 31, 2017). The hazard ratio (HR), and sub-hazards ratio (SHR), in which death was considered as a competing risk, of developing renal cell carcinoma or urothelial cancer were compared between the HD and PD patients. RESULTS The incidence rate of renal cell carcinoma was higher in the PD group than in age-, sex-, and index year-matched HD group (11.5 versus 5.52 per 10,000 person-years), with an adjusted HR of 2.15 (95% confidence interval (CI) = 1.59, 2.92), and an adjusted SHR of 1.97 (95% CI = 1.46, 2.67). The incidence rate of urothelial cancer was also higher in the PD group than in corresponding HD group (40.3 and 34.0 per 10,000 person-years), with an adjusted HR of 1.15 (95% CI = 1.00, 1.33) and an adjusted SHR of 1.08 (95% CI = 0.94, 1.25). These findings were further validated in propensity score-matched dialysis cohorts. CONCLUSIONS ESKD patients undergoing PD are at a higher risk of developing renal cell carcinoma than those on HD, but risks of developing urothelial cancer are similar among the two groups.
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Affiliation(s)
- I-Kuan Wang
- Graduate Institute of Biological Sciences, College of Medicine, China Medical University, Taichung, Taiwan
- Division of Nephrology, China Medical University Hosptal, Taichung, Taiwan
| | - Tung-Min Yu
- Division of Nephrology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tzung-Hai Yen
- Division of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chi-Yuan Li
- Graduate Institute of Biological Sciences, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Anesthesiology, China Medical University Hospital, Taichung, Taiwan
| | - Chieh-Min Hsu
- Department of Anesthesiology, China Medical University Hospital, Taichung, Taiwan
| | - Tsung-Hsun Tsai
- Division of Urology, Department of Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
- Department of Health Services Administration, China Medical University College of Public Health, Taichung, Taiwan.
- Department of Food Nutrition and Health Biotechnology, Asia University, 500 Lioufeng Rd Wufeng, Taichung, 413, Taiwan.
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Yang Y, Chen H, Li Y, Zhou J. Case Report: The ultrasound features of acquired cystic disease-associated renal cell carcinoma: a case series. Front Oncol 2023; 13:1187495. [PMID: 37333808 PMCID: PMC10269903 DOI: 10.3389/fonc.2023.1187495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/10/2023] [Indexed: 06/20/2023] Open
Abstract
Background Acquired cystic disease-associated renal cell carcinoma (ACD-RCC) is a new subtype listed by the 2016 World Health Organization (WHO) classification, which occurred in end-stage renal disease (ESRD) patients. This study will present the imaging characteristics of the four cases diagnosed with ACD-RCC. Ultrasound is expected to help detect abnormalities early in the follow-up of patients on regular dialysis, allowing patients to receive early treatment. Case presentation We searched the pathology database of our hospital for all inpatients diagnosed with ACD-RCC between January 2016 and May 2022. Pathology, ultrasound, and radiology readings are performed by experienced physicians with the title of attending physician or higher. Four cases were included in this study, all of whom were male, aged from 17 to 59. Two cases suffered from ACD-RCC in both kidneys, and kidney nephrectomies were performed. One case underwent renal transplantation, whose creatinine was back to normal, and the rest were on hemodialysis. On the pathological images, heteromorphic cells and oxalate crystals can be seen. Both ultrasound and enhanced CT showed an enhancement of the solid component of the occupancy. We followed up with outpatient and telephone visits. Conclusion In clinical work, ACD-RCC should be considered when the mass appears in the background of multiple cysts in the kidney in patients with ESRD. A timely diagnosis will help with treatment and prognosis.
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Imran N. Acquired Perforating Dermatosis as a Paraneoplastic Feature: A Case Report, Literature Review, and Novel Association. Case Rep Nephrol Dial 2023; 13:36-44. [PMID: 37384123 PMCID: PMC10294214 DOI: 10.1159/000530756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/07/2023] [Indexed: 06/30/2023] Open
Abstract
Kyrle's disease is an uncommon form of acquired transepidermal elimination dermatosis frequently associated with diabetes mellitus and chronic kidney disease. An association with malignancy has been sporadically reported in the literature. Here, we describe the clinical course of a diabetic patient with end-stage renal disease who developed this disorder as a herald to a regionally advanced renal cell carcinoma. We provide a focused literature review and rationale for the definitive categorization of acquired perforating dermatosis as a potential paraneoplastic manifestation of systemic malignancies. Clinicopathological correlation and prompt communication among clinicians for occult malignancies are always warranted. Furthermore, we describe a novel association of one of the subtypes of acquired perforating dermatosis with such malignancies.
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Affiliation(s)
- Nashat Imran
- Internal Medicine Department, Wayne State University School of Medicine, Detroit, MI, USA
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8
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El-Zaatari ZM, Truong LD. Renal Cell Carcinoma in End-Stage Renal Disease: A Review and Update. Biomedicines 2022; 10:biomedicines10030657. [PMID: 35327459 PMCID: PMC8944945 DOI: 10.3390/biomedicines10030657] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 11/16/2022] Open
Abstract
Renal cell carcinoma (RCC) occurring in the setting of end-stage renal disease (ESRD) shows unique clinicopathological characteristics. The two most frequent types of ESRD-associated RCC are acquired cystic kidney disease-associated renal cell carcinoma (ACKD-RCC) and clear-cell papillary renal cell carcinoma (ccpRCC). Other types of RCC also occur in ESRD, albeit with different frequencies from the non-ESRD general population. The histological features of RCC do not vary in the setting of ESRD vs. non-ESRD, yet other findings, such as multifocality and multiple tumor types, are more frequent in ESRD. Studies have generated novel and important knowledge of the etiology, epidemiology, diagnosis, treatment, immunophenotype, and molecular characteristics of ESRD-associated RCC. Knowledge of these data is important for both pathologists and other physicians who may encounter ESRD patients with RCC. This review presents a comprehensive summary and update of the literature on RCC in ESRD, with a focus on the two most frequent types, ACKD-RCC and ccpRCC.
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Affiliation(s)
- Ziad M. El-Zaatari
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Main Building, Houston, TX 77030, USA;
- Weil Medical College, Cornell University, New York, NY 10022, USA
- Correspondence: ; Tel.: +1-713-441-6478; Fax: +1-713-793-1603
| | - Luan D. Truong
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Main Building, Houston, TX 77030, USA;
- Weil Medical College, Cornell University, New York, NY 10022, USA
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Berkenblit R, Ricci Z, Kanmaniraja D, Sarungbam J. CT features of acquired cystic kidney disease-associated renal cell carcinoma. Clin Imaging 2022; 83:83-86. [PMID: 35007888 DOI: 10.1016/j.clinimag.2021.12.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/07/2021] [Accepted: 12/29/2021] [Indexed: 11/15/2022]
Abstract
PURPOSE Acquired cystic kidney disease-associated renal cell carcinoma (ACKD-RCC) is a relatively recently described entity with scarce literature describing its imaging appearance (1, 2). The purpose of this study was to determine typical and potentially unique features of ACKD-RCC on CT scan that could aid lesion identification. MATERIALS AND METHODS A retrospective review of the CT scans of 24 patients with 29 histologically proven ACKD-RCC lesions was performed. Imaging features were recorded based on consensus readings of two radiologists. RESULTS Tumors ranged in size from 1.2 to 5 cm. Nineteen lesions were right-sided and 10 left-sided. Nineteen lesions were exophytic. One patient had bilateral lesions and three patients had multiple lesions in the same kidney. All lesions had well-defined margins with 21 round, 7 lobulated and 1 crescentic in shape. On non-enhanced exam 4 lesions were hypodense, 16 iso-dense and 9 hyperdense; 5 had gross calcifications. Twenty two patients had contrast-enhanced CT exams, with 13 lesions demonstrating homogeneous enhancement (solid pattern) and 14 having inhomogeneous enhancement (cystic or mixed solid and cystic pattern). Only 1 patient had metastatic disease. Eight patients had a history of renal transplants. CONCLUSION ACKD-RCCs are well-defined lesions of variable size that are almost always rounded and most often exophytic. They occasionally have calcifications and are not uncommonly hyperdense on non-enhanced exam. They are most often iso-dense on non-enhanced exam and can be solid, cystic or mixed in attenuation on enhanced exam.
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Affiliation(s)
- Robert Berkenblit
- Department of Radiology, Montefiore Medical Center, Bronx, NY, United States of America.
| | - Zina Ricci
- Department of Radiology, Montefiore Medical Center, Bronx, NY, United States of America
| | - Devaraju Kanmaniraja
- Department of Radiology, Montefiore Medical Center, Bronx, NY, United States of America
| | - Judy Sarungbam
- Department of Pathology, Memorial Sloan Kettering Hospital, New York, NY, United States of America
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Chrabańska M, Ryszawy J, Drozdzowska B. Acquired cystic disease-associated renal cell carcinoma: A clinicopathologic study of eight tumors with clinical follow-up. Indian J Cancer 2022; 58:608-614. [PMID: 34975102 DOI: 10.4103/ijc.ijc_720_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Acquired cystic disease-associated renal cell carcinoma (ACD-RCC) is the major RCC subtype in patients with end-stage renal disease, specifically those with ACD on dialysis. Three patients with a total of eight tumors have been selected. The aim of this study was to analyze clinicopathologic, immunohistochemical, and prognostic features of eight ACD-RCCs. Three patients with end-stage renal disease (ESRD) were in the age range of 34-45 years and being treated with hemodialysis. All eight tumors were resected by radical nephrectomy. Two patients had a single ACD-RCC, while one patient had bilateral and multifocal ACD-RCCs. Microscopically, combinations of architectural patterns were identified in all tumors. Intracytoplasmic and intraluminal vacuoles, eosinophilic granular cytoplasm, and prominent nucleoli were universal characteristics of these tumors. Atypical cysts were present in three out of four resected kidneys. Immunohistochemistry (IHC) staining revealed all tumors were strongly and diffusely positive for pan-cytokeratin and α-methylacyl-CoA racemase and variably positive for CK7, CD10, PAX8, EMA, vimentin, cytokeratin, high molecular weight cytokeratin (CK HMW). All cases were negative for Napsin A, CK20, CD117, and CD57. After an average follow-up of 27.5 months (range 3-54 months), all our patients are alive without neoplastic (metastatic or recurrent) disease. Our study supports the finding that ACD-RCC has specific morphologic features and a broad spectrum of architectural patterns. We have found that the immunoprofile of ACD-RCC is distinct from that in other RCCs; however, nonspecific and interpretation of microscopic features in the context of the clinical history can aid the diagnosis. We confirm also the favorable prognosis in ACD-RCC.
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Affiliation(s)
- Magdalena Chrabańska
- Departments Chair of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Jakub Ryszawy
- Clinic of Urology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Bogna Drozdzowska
- Departments Chair of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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Wong AD, Laniesse D, Zur Linden A, Singh A, Susta L, Beaufrère H. Development of renal adenocarcinoma in a ferret with renal cortical cysts (Mustela putorius furo). J Am Vet Med Assoc 2021; 259:1452-1459. [PMID: 34757937 DOI: 10.2460/javma.20.09.0520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 5.5-year-old 0.929-kg spayed female domestic ferret (Mustela putorius furo) underwent serial abdominal ultrasonographic and clinicopathologic examinations after multiple renal cysts were detected bilaterally during a routine examination. CLINICAL FINDINGS The ferret was apparently healthy at the start of the monitoring period and had no clinical signs for > 20 months. Four months after the initial examination, the largest cyst became increasingly mineralized; 17 months after detection, it had increased in size and become amorphous, and the ferret's plasma BUN concentration was mildly high. Within 21 months after the first visit, a nodule was detectable, and hydronephrosis developed in the kidney with the largest cyst. Findings for fine-needle aspirates from the nodule were consistent with renal carcinoma. TREATMENT AND OUTCOME Contrast-enhanced CT revealed severe unilateral nephromegaly with no contrast uptake in the affected ureter. Following surgical removal of the affected kidney, histologic examination identified renal adenocarcinoma replacing the entire renal cortex and medulla. The ferret was euthanized postoperatively because of declining condition. On necropsy, metastasis to a mesenteric lymph node was identified; comorbidities included 2 other neoplasms and acute, severe injury of the contralateral kidney. CLINICAL RELEVANCE Neoplastic transformation of a renal cyst was suspected in the ferret of this report on the basis of observed ultrasonographic changes over time and extensive infiltration of the neoplasm throughout the affected kidney. Renal cysts are linked to renal neoplasia in other species, and the findings for this patient supported the need for periodic monitoring of renal cysts in ferrets.
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Affiliation(s)
- Amanda D Wong
- From the Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802
| | | | - Alex Zur Linden
- From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Ameet Singh
- From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Leonardo Susta
- From the Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Hugues Beaufrère
- From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada
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Yamazaki H, Koike T, Imamura T, Kobayashi S, Fujioka H, Kakeshita K, Iida H, Minamisaka T, Kinugawa K. Renal Cell Carcinoma on the Native Kidney Following Kidney Transplantation. Transplant Proc 2021; 53:1268-1271. [PMID: 33715820 DOI: 10.1016/j.transproceed.2021.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/30/2020] [Accepted: 02/01/2021] [Indexed: 10/21/2022]
Abstract
A 48-year-old man with histories of IgA nephropathy for 33 years, hemodialysis for 29 years, and a kidney transplant from a deceased donor 5 years ago was admitted to our institute complaining of high fever and back pain. Although repeated follow-up of computed tomography failed to detect any de novo issues, he was eventually diagnosed as a renal cell carcinoma with multiple metastases, developing from his native-acquired cystic disease kidney with multiple cysts using a positron emission tomography. We should be cautious of de novo renal cell carcinoma in kidney transplantation recipients, and careful follow-up might be helpful to detect it.
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Affiliation(s)
- Hidenori Yamazaki
- The Second Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Tsutomu Koike
- The Second Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Teruhiko Imamura
- The Second Department of Internal Medicine, University of Toyama, Toyama, Japan.
| | - Shiori Kobayashi
- The Second Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Hayato Fujioka
- The Second Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Kota Kakeshita
- The Second Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Hiroaki Iida
- Department of Urology, University of Toyama, Toyama, Japan
| | | | - Koichiro Kinugawa
- The Second Department of Internal Medicine, University of Toyama, Toyama, Japan
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13
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Wang YL, Zhang YY. cg04448376, cg24387542, cg08548498, and cg14621323 as a Novel Signature to Predict Prognosis in Kidney Renal Papillary Cell Carcinoma. BIOMED RESEARCH INTERNATIONAL 2020; 2020:4854390. [PMID: 33381555 PMCID: PMC7759405 DOI: 10.1155/2020/4854390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/19/2020] [Accepted: 11/28/2020] [Indexed: 10/26/2022]
Abstract
INTRODUCTION DNA methylation plays a vital role in prognosis prediction of cancers. In this study, we aimed to identify novel DNA methylation site biomarkers and create an efficient methylated site model for predicting survival in kidney renal papillary cell carcinoma (KIRP). METHODS DNA methylation and gene expression profile data were downloaded from The Cancer Genome Atlas (TCGA) database and the Gene Expression Omnibus (GEO) database. Differential methylated genes (DMGs) and differential expression genes (DEGs) were identified and then searched for the hub genes. Cox proportional hazards regression was applied to identify DNA methylated site biomarkers from the hub genes. Kaplan-Meier survival and ROC analyses were used to validate the effective prognostic ability of the methylation gene site biomarker. The biomarker sites were validated in the GEO cohorts. The GO and KEGG annotation was done to explore the biological function of DNA methylated site signature. RESULTS Nine DMGs with opposite expression patterns containing 47 methylated sites were identified. Finally, four methylated sites were identified using the hazard regression model (cg04448376, cg24387542, cg08548498, and cg14621323) located in UTY, LGALS9B, SLPI, and PFN3, respectively. These sites classified patients into high- and low-risk groups in the training cohort. The 5-year survival rates for patients with low-risk and high-risk scores were 97.5% and 75.9% (P < 0.001). The prognostic accuracy and signature methylation sites were validated in the test (TCGA, n = 87) and GEO cohorts (n = 14). Multivariate regression analysis showed that the signature was an independent prediction prognostic factor for KIRP. Based on this analysis, we developed methylated site signature nomogram that predicts an individual's risk of survival. Functional analysis suggested that these signature genes are involved in the biological processes of protein binding. CONCLUSIONS Our study demonstrated that the methylated gene site signature might be a powerful prognostic tool for evaluating survival rate and guiding tailored therapy for KIRP patients.
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Affiliation(s)
- Ying-Lei Wang
- Department of Urinary Surgery, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Ying-Ying Zhang
- Out-patient Department, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
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14
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Yang H, Wei Q, Li D, Wang Z. Cancer classification based on chromatin accessibility profiles with deep adversarial learning model. PLoS Comput Biol 2020; 16:e1008405. [PMID: 33166290 PMCID: PMC7676699 DOI: 10.1371/journal.pcbi.1008405] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 11/19/2020] [Accepted: 09/28/2020] [Indexed: 12/13/2022] Open
Abstract
Given the complexity and diversity of the cancer genomics profiles, it is challenging to identify distinct clusters from different cancer types. Numerous analyses have been conducted for this propose. Still, the methods they used always do not directly support the high-dimensional omics data across the whole genome (Such as ATAC-seq profiles). In this study, based on the deep adversarial learning, we present an end-to-end approach ClusterATAC to leverage high-dimensional features and explore the classification results. On the ATAC-seq dataset and RNA-seq dataset, ClusterATAC has achieved excellent performance. Since ATAC-seq data plays a crucial role in the study of the effects of non-coding regions on the molecular classification of cancers, we explore the clustering solution obtained by ClusterATAC on the pan-cancer ATAC dataset. In this solution, more than 70% of the clustering are single-tumor-type-dominant, and the vast majority of the remaining clusters are associated with similar tumor types. We explore the representative non-coding loci and their linked genes of each cluster and verify some results by the literature search. These results suggest that a large number of non-coding loci affect the development and progression of cancer through its linked genes, which can potentially advance cancer diagnosis and therapy.
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Affiliation(s)
- Hai Yang
- Department of Computer Science and Engineering, East China University of Science and Technology, Shanghai, PR China
| | - Qiang Wei
- Department of Molecular Physiology & Biophysics, Vanderbilt University, Nashville, Tennessee, United States of America
- Vanderbilt Genetics Institute, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Dongdong Li
- Department of Computer Science and Engineering, East China University of Science and Technology, Shanghai, PR China
| | - Zhe Wang
- Department of Computer Science and Engineering, East China University of Science and Technology, Shanghai, PR China
- * E-mail:
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15
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Edo H, Suyama Y, Sugiura H, Ojima K, Ito K, Miyai K, Matsukuma S, Shinmoto H. Acquired Cystic Disease-Associated Renal Cell Carcinoma Extending to the Renal Pelvis Mimicking Urothelial Carcinoma on Computed Tomography (CT): Two Case Reports. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e926630. [PMID: 33075039 PMCID: PMC7585458 DOI: 10.12659/ajcr.926630] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Case series Patients: Male, 66-year-old • Male, 67-year-old Final Diagnosis: Acquired cystic disease-associated renal cell carcinoma Symptoms: Hematuria Medication: — Clinical Procedure: — Specialty: Oncology • Radiology
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Affiliation(s)
- Hiromi Edo
- Department of Radiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yohsuke Suyama
- Department of Radiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Hiroaki Sugiura
- Department of Radiology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Kenichiro Ojima
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Keiichi Ito
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Kosuke Miyai
- Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Susumu Matsukuma
- Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Hiroshi Shinmoto
- Department of Radiology, National Defense Medical College, Tokorozawa, Saitama, Japan
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16
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Zhong W, Huang C, Lin J, Zhu M, Zhong H, Chiang MH, Chiang HS, Hui MS, Lin Y, Huang J. Development and Validation of Nine-RNA Binding Protein Signature Predicting Overall Survival for Kidney Renal Clear Cell Carcinoma. Front Genet 2020; 11:568192. [PMID: 33133154 PMCID: PMC7566920 DOI: 10.3389/fgene.2020.568192] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/31/2020] [Indexed: 12/20/2022] Open
Abstract
Cumulative studies have shown that RNA binding proteins (RBPs) play an important role in numerous malignant tumors and are related to the occurrence and progression of tumors. However, the role of RBPs in kidney renal clear cell carcinoma (KIRC) is not fully understood. In this study, we first downloaded gene expression data and corresponding clinical information of KIRC from the Cancer Genome Atlas (TCGA) database, International Cancer Genome Consortium (ICGC), and Gene Expression Omnibus (GEO) database, respectively. A total of 137 differentially expressed RBPs (DERBPs) were then identified between normal and tumor tissue, including 38 downregulated and 99 upregulated RBPs. Nine RBPs (EIF4A1, RPL36A, EXOSC5, RPL28, RPL13, RPS19, RPS2, EEF1A2, and OASL) were served as prognostic genes and exploited to construct a prognostic model through survival analysis. Kaplan-Meier curves analysis showed that the low-risk group had a better survival outcome when compared with the high-risk group. The area under the curve (AUC) value of the prognostic model was 0.713 in the TCGA data set (training data set), 0.706 in the ICGC data set, and 0.687 in the GSE29609 data set, respectively, confirming a good prognostic model. The prognostic model was also identified as an independent prognostic factor for KIRC survival by performing cox regression analysis. In addition, we also built a nomogram relying on age and the prognostic model and internal validation in the TCGA data set. The clinical benefit of the prognostic model was revealed by decision curve analysis (DCA). Gene set enrichment analysis revealed several crucial pathways (ERBB signaling pathway, pathways in cancer, MTOR signaling pathway, WNT signaling pathway, and TGF BETA signaling pathway) that may explain the underlying mechanisms of KIRC. Furthermore, potential drugs for KIRC treatment were predicted by the Connectivity Map (Cmap) database based on DERBPs, including several important drugs, such as depudecin and vorinostat, that could reverse KIRC gene expression, which may provide reference for the treatment of KIRC. In summary, we developed and validated a robust nine-RBP signature for KIRC prognosis prediction. A nomogram with risk score and age can be applied to promote the individualized prediction of overall survival in patients with KIRC. Moreover, the two drugs depudecin and vorinostat may contribute to KIRC treatment.
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Affiliation(s)
| | | | | | - Maoshu Zhu
- The Fifth Hospital of Xiamen, Xiamen, China
| | | | - Ming-Hsien Chiang
- Taiwan LinkMed Asia Public Health & Healthcare Management Research Association, Taipei, Taiwan
| | - Huei-Shien Chiang
- Taiwan LinkMed Asia Public Health & Healthcare Management Research Association, Taipei, Taiwan
| | | | - Yao Lin
- Key Laboratory of Optoelectronic Science and Technology for Medicine of Ministry of Education, College of Life Sciences, Fujian Normal University, Fuzhou, China
| | - Jiyi Huang
- The Fifth Hospital of Xiamen, Xiamen, China.,Xiang'an Branch, The First Affiliated Hospital of Xiamen University, Xiamen University, Xiamen, China
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17
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Chrabańska M, Jakub R, Bogna D. Bilateral and Multifocal Acquired Cystic Disease-Associated Renal Cell Carcinomas in Patient With End-Stage Renal Disease Caused by Systemic Lupus Erythematosus. Int J Surg Pathol 2020; 29:198-204. [PMID: 32513033 DOI: 10.1177/1066896920928586] [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] [Indexed: 01/20/2023]
Abstract
The disease entity of acquired cystic disease-associated renal cell carcinoma (ACD-RCC) has been recently incorporated into the international renal tumor classification. We performed a clinicopathologic study of a patient with bilateral and multifocal ACD-RCCs. The patient received long-term hemodialysis in the end-stage renal disease caused by systemic lupus erythematous. First left-sided nephrectomy and after 6 months right-sided nephrectomy was performed. None of the preoperative radiologic examinations revealed lesions suspected of malignancy. All of the 6 tumors were incidentally found on grossing radical nephrectomy specimens. Histologically, tumors consisted of a variety of growth patterns (including papillary and cribriform) of neoplastic cells with granular eosinophilic cytoplasm and intratumoral oxalate crystals. Neoplastic cells were positive for AMACR, CK AE1/AE3, and CD10; focally positive for CK7; and negative for PAX8. Seven months after the first nephrectomy, the patient still receives dialysis. There was no evidence of lymph node or distant metastases.
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Affiliation(s)
- Magdalena Chrabańska
- Department and Chair of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Ryszawy Jakub
- Department and Clinic of Urology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Drozdzowska Bogna
- Department and Chair of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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18
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Update on Renal Neoplasms: Clinicopathologic-Radiologic Correlation With Case-Based Examples. AJR Am J Roentgenol 2020; 214:1220-1228. [PMID: 32286867 DOI: 10.2214/ajr.20.22816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. This article provides a brief overview of the clinicopathologic and radiologic correlation of 12 renal neoplasms, encompassing the conventional subtypes of renal cell carcinoma and a few of the newly recognized subtypes from the 2016 World Health Organization classification of renal tumors. In addition, we touch upon infrequent neoplasms that may enter the differential diagnosis of a renal mass, with corresponding radiologic and gross images and histologic findings of case-based examples. CONCLUSION. Familiarity with the radiologic and pathologic characteristics of renal cell carcinoma and other renal neoplasms is important to correctly identify and treat these masses.
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19
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Taylor AS, Spratt DE, Dhanasekaran SM, Mehra R. Contemporary Renal Tumor Categorization With Biomarker and Translational Updates: A Practical Review. Arch Pathol Lab Med 2020; 143:1477-1491. [PMID: 31765248 DOI: 10.5858/arpa.2019-0442-ra] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Renal tumor classification has evolved in recent decades, as evidenced by the comparable complexity of the 2016 revision to the World Health Organization Classification of Tumours of the Urinary System and Male Genital Organs. A recent expansion of the knowledge base surrounding the cells of origin and evolutionary genomic characteristics of renal tumors has led to molecular characterization of novel entities and enriched understanding of established entities. This pace of research and its implementation into clinical practice has again begun to surpass that of our own classification schemata, with significant discoveries having been made since the introduction of the 2016 revision to the World Health Organization classification. In particular, biomarkers for renal tumor diagnosis and prognosis are in translation for future clinical application. OBJECTIVES.— To provide a brief framework for clinical characterization of renal tumors rooted in morphologic assessment, to briefly review the current and future status of renal tumor biomarkers with an emphasis on practical use of these ancillary tools for accurate diagnosis, and to discuss the impact of emerging technologies and clinical trials relevant to renal cell carcinoma classification and biomarker development. DATA SOURCES.— We review recent literature relevant to renal tumor classification (including established and proposed entities), focusing on molecular characterization and biomarker assessment. CONCLUSIONS.— Accurate renal tumor diagnosis requires an up-to-date understanding of renal tumor classification, including an awareness of morphologic clues that should stimulate consideration of molecularly defined entities, as well as the ancillary biomarker testing required to confirm diagnoses.
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Affiliation(s)
- Alexander S Taylor
- From the Departments of Pathology (Drs Taylor, Dhanasekaran, and Mehra) and Radiation Oncology (Dr Spratt), University of Michigan Medical School, Ann Arbor; the Rogel Cancer Center, Michigan Medicine, Ann Arbor (Drs Spratt and Mehra); and the Michigan Center for Translational Pathology, Ann Arbor (Drs Dhanasekaran and Mehra)
| | - Daniel E Spratt
- From the Departments of Pathology (Drs Taylor, Dhanasekaran, and Mehra) and Radiation Oncology (Dr Spratt), University of Michigan Medical School, Ann Arbor; the Rogel Cancer Center, Michigan Medicine, Ann Arbor (Drs Spratt and Mehra); and the Michigan Center for Translational Pathology, Ann Arbor (Drs Dhanasekaran and Mehra)
| | - Saravana M Dhanasekaran
- From the Departments of Pathology (Drs Taylor, Dhanasekaran, and Mehra) and Radiation Oncology (Dr Spratt), University of Michigan Medical School, Ann Arbor; the Rogel Cancer Center, Michigan Medicine, Ann Arbor (Drs Spratt and Mehra); and the Michigan Center for Translational Pathology, Ann Arbor (Drs Dhanasekaran and Mehra)
| | - Rohit Mehra
- From the Departments of Pathology (Drs Taylor, Dhanasekaran, and Mehra) and Radiation Oncology (Dr Spratt), University of Michigan Medical School, Ann Arbor; the Rogel Cancer Center, Michigan Medicine, Ann Arbor (Drs Spratt and Mehra); and the Michigan Center for Translational Pathology, Ann Arbor (Drs Dhanasekaran and Mehra)
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20
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New and Emerging Subtypes of Renal Cell Carcinoma. KIDNEY CANCER 2020. [DOI: 10.1007/978-3-030-28333-9_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Iatrogenic Disease of the Genitourinary Tract. Adv Anat Pathol 2019; 26:171-185. [PMID: 30720471 DOI: 10.1097/pap.0000000000000226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Iatrogenic disease is defined as illness caused by diagnostic procedures or treatment given by health care professionals. More recently described treatment complications involving the genitourinary tract include newly recognized variants of renal carcinoma in the setting of dialysis/end-stage renal disease, treatment effect in genitourinary carcinomas, and medical renal disease caused by drug therapies, including immunotherapy. The objective of this review is to cover iatrogenic inflammatory diseases, pseudotumors and tumors of the kidney, bladder, prostate, testis and paratestis of most interest to surgical pathologists. For this reason, disease caused by the following will not be covered: iatrogenic glomerulonephritis, self-inflicted injury including the introduction of foreign bodies, surgical error, drugs of abuse and herbal medications, and iatrogenic disease in the transplant setting including ischemia/reperfusion injury. Emphasis is placed upon commonly encountered diseases in order to ensure that the review is of utility to practicing pathologists. The clinical context, pathophysiology and histopathology of each disease entity are covered.
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22
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Boissier R, Ouzaid I, Nouhaud FX, Khene Z, Dariane C, Chkir S, Chelly S, Giwerc A, Allenet C, Lefrancq JB, Gimel P, Bodin T, Rioux-Leclercq N, Correas JM, Albiges L, Hetet JF, Bigot P, Bernhard JC, Long JA, Mejean A, Bensalah K. Long-term oncological outcomes of cystic renal cell carcinoma according to the Bosniak classification. Int Urol Nephrol 2019; 51:951-958. [PMID: 30977021 DOI: 10.1007/s11255-019-02085-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 01/17/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To evaluate the prognostic role of the Bosniak classification on the long-term oncological outcomes of cystic renal cell carcinomas. MATERIAL AND METHOD In a national multicentric retrospective study, we included patients treated surgically for localized cystic RCC from 2000 to 2010. Patients with a follow-up of less than 4 years, benign tumors, and ablative treatments were excluded. The primary outcome was disease-free survival. RESULTS 152 patients met the inclusion criteria: Bosniak II (6%), III (53%), IV (41%), with a median follow-up of 61 (12-179) months. Characteristics of the population and the tumors were [median, (min-max)] age 57 (25-84) years old, tumor size 43 mm (20-280), RENAL score 7 (4-12), PADUA score 8 (5-14). Treatments were 55% partial nephrectomy, 45% radical nephrectomy, 74% open surgery, and 26% laparoscopy. In pathological report, cystic RCC were mainly of low grade (1-2, 77%) and low stage (pT1, 81%). The two main histological subtypes were conventional (56%) and papillary (23%) RCC. Staging at presentation and histological characteristics were similar between Bosniak III and IV, except for high grade which was more common in Bosniak IV (12 vs 36%, p < 0.01). The Bosniak classification was not predictive of the recurrence, as 5- and 10-year disease-free survival were similar in Bosniak III and IV (92% vs 92% and 84% vs 83%, p = 0.60). CONCLUSION The Bosniak classification is predictive of the risk of malignancy but not of the oncological prognosis. Regardless of the initial Bosniak categories, almost all cystic RCCs were of low stage/grade and had low long-term recurrence rate.
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Affiliation(s)
- R Boissier
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, 13005, Marseille, France.
| | - I Ouzaid
- Urology Department, Bichat-Claude-Bernard, Paris, France
| | - F X Nouhaud
- Urology Department, Rouen University Hospital, Rouen, France
| | - Z Khene
- Urology Department, Rennes University Hospital, Rennes, France
| | - C Dariane
- Urology Department, Georges Pompidou University Hospital, Paris, France
| | - S Chkir
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, 13005, Marseille, France
| | - S Chelly
- Urology Department, Angers University Hospital, Angers, France
| | - A Giwerc
- Urology Department, Rouen University Hospital, Rouen, France
| | - C Allenet
- Urology Department, Bordeaux University Hospital, Bordeaux, France
| | - J B Lefrancq
- Urology Department, Grenoble University Hospital, La Tronche, France
| | - P Gimel
- Urology Department, Medipole, Cabestany, France
| | - T Bodin
- Urology Department, Saint-Joseph Hospital, Marseille, France
| | - N Rioux-Leclercq
- Pathology Department, Rennes University Hospital, Rennes, France
| | - J M Correas
- Radiology Department, Georges Pompidou University Hospital, Paris, France
| | - L Albiges
- Oncology Department, Gustave Roussy Institute, Paris, France
| | - J F Hetet
- Urology Department, Clinique Jules Verne, Nantes, France
| | - P Bigot
- Urology Department, Angers University Hospital, Angers, France
| | - J C Bernhard
- Urology Department, Bordeaux University Hospital, Bordeaux, France
| | - J A Long
- Urology Department, Grenoble University Hospital, La Tronche, France
| | - A Mejean
- Urology Department, Georges Pompidou University Hospital, Paris, France
| | - K Bensalah
- Urology Department, Rennes University Hospital, Rennes, France
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23
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Imaging of renal cell carcinoma in patients with acquired cystic disease of the kidney: comparison 11C-choline and FDG PET/CT with dynamic contrast-enhanced CT. Jpn J Radiol 2018; 37:165-177. [PMID: 30377936 DOI: 10.1007/s11604-018-0789-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 10/25/2018] [Indexed: 01/14/2023]
Abstract
PURPOSE To evaluate renal cell carcinoma (RCC) findings in acquired cystic disease of the kidney (ACDK) shown by 11C-choline and FDG PET/CT, and contrast-enhanced CT. MATERIALS AND METHODS Six ACDK patients with 7 RCCs underwent 11C-choline and FDG PET/CT, and contrast-enhanced CT before nephrectomy. Findings obtained with 3 imagings were evaluated and sensitivity detecting RCC was compared using 3-point grading scale (negative, equivocal, positive). The equivocal scale used for SUVmax ranged from 2.0 to 3.0 for PET/CT and a peak enhancement value ranging from 20 to 30 HU was used for CT. RESULT The histopathologic subtypes of 7 RCCs were clear-cell (n = 4) and ACD-associated RCC (n = 3). The negative/equivocal/positive grading results were 0/0/7 for 11C-choline-PET/CT, 0/3/4 for FDG-PET/CT, and 2/2/3 for CT. Three equivocal cases by FDG-PET/CT were 2 clear-cell RCCs and 1 ACD-associated RCC. CT of 3 ACD-associated RCCs showed negativity for 2 and equivocality for 1. Sensitivity defining equivocal interpretation as negative for 11C-choline-PET/CT, FDG-PET/CT, and CT was 100% (7/7), 57.1% (4/7), and 42.9% (3/7). CONCLUSION 11C-choline-PET/CT was more sensitive to detect RCC in ACDK as compared to FDG-PET/CT and contrast-enhanced CT in our series. FDG-PET/CT may be limited for detecting clear-cell RCC, while CT may have difficulty with detection of ACD-associated RCC.
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Tatsugami K. Editorial Comment to Renal tumors in end-stage renal disease: A comprehensive review. Int J Urol 2018; 25:786-787. [PMID: 30182509 DOI: 10.1111/iju.13795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Katsunori Tatsugami
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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25
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Chen T, Achan A, Wong G. Acquired cystic disease-associated renal cell carcinoma. Nephrology (Carlton) 2018; 23:704-705. [PMID: 30133972 DOI: 10.1111/nep.13166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Titi Chen
- School of Medicine, The University of Sydney, Camperdown, New South Wales, Australia.,Department of Renal Medicine, Westmead Hospital, Westmead, New South Wales, Australia.,Centre for Transplant and Renal Research, The Westmead Institute for Medical Research, Westmead, New South Wales, Australia
| | - Anita Achan
- Department of Anatomical Pathology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Germaine Wong
- School of Medicine, The University of Sydney, Camperdown, New South Wales, Australia.,Department of Renal Medicine, Westmead Hospital, Westmead, New South Wales, Australia.,Centre for Transplant and Renal Research, The Westmead Institute for Medical Research, Westmead, New South Wales, Australia
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26
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Latest Novelties on the World Health Organization Morphological Classifications of Genitourinary Cancers. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.eursup.2017.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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27
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Lan H, Zeng J, Chen G, Huang H. Survival prediction of kidney renal papillary cell carcinoma by comprehensive LncRNA characterization. Oncotarget 2017; 8:110811-110829. [PMID: 29340018 PMCID: PMC5762286 DOI: 10.18632/oncotarget.22732] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/09/2017] [Indexed: 02/07/2023] Open
Abstract
Kidney renal papillary cell carcinoma (KIRP) accounts for 10%-15% of renal cell carcinoma (RCC), patients with KIRP tend to have a poor prognosis, and there was a lack of effective prognostic indicators for this type of cancer. Currently, owing to the availability of The Cancer Genome Atlas (TCGA), long non-coding RNAs (LncRNAs) have been discovered to indicate a prognostic value in some tumors. In that regard, we analyzed lncRNA-sequencing data of KIRP in TCGA, and among 780 differentially-expressed lncRNAs, we selected 37 lncRNAs which were able to assist the prognosis. In addition, by using the multivariate cox regression analysis, the prognosis index (PI) that consisted of 7 lncRNAs (including AFAP1-AS1, GAS6-AS1, RP11-1C8.7, RP11-21L19.1, RP11-503C24.1, RP11-536I6.2, and RP11-63A11.1) could predict the progression and outcomes of KIRP with accuracy. More importantly, the PI was considered an independent indicator for prognostication of KIRP. Moreover, having categorized patients with KIRP into cohorts of high risk and low risk, according to the PI, we found that the key genes and pathways varied in these two groups. Overall, these LncRNAs, especially the PI, may be conceived as biomarkers and helpful for determining the different pathological stages for KIRP patients. However, their biological functions need to be further confirmed.
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Affiliation(s)
- Huihua Lan
- Department of Laboratory Medicine, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Jianghui Zeng
- Department of Laboratory Medicine, The Third Affiliated Hospital of Guangxi Medical University/The Second People's Hospital of the City of Nanning, Nanning, Guangxi, China
| | - Gang Chen
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Huayi Huang
- Department of Laboratory Medicine, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.,Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, New York, USA
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Inamura K. Renal Cell Tumors: Understanding Their Molecular Pathological Epidemiology and the 2016 WHO Classification. Int J Mol Sci 2017; 18:E2195. [PMID: 29053609 PMCID: PMC5666876 DOI: 10.3390/ijms18102195] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/14/2017] [Accepted: 10/17/2017] [Indexed: 02/06/2023] Open
Abstract
Accumulating evidence suggests that renal cell tumors represent a group of histologically and molecularly heterogeneous diseases, even within the same histological subtype. In accordance with the increased understanding of the morphological, immunohistochemical, molecular, and epidemiological characteristics of renal cell tumors, the World Health Organization (WHO) classification of renal cell tumors has been modified. This review provides perspectives on both new and current subtypes of renal cell tumors, as well as on the emerging/provisional renal cell carcinomas in the new 2016 WHO classification, which focuses on features of their molecular pathological epidemiology. The WHO classification will require additional revisions to enable the classification of renal cell tumors as clinically meaningful subtypes and provide a better understanding of the unique characteristics of renal cell tumors.
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Affiliation(s)
- Kentaro Inamura
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan.
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Billis A, Freitas L, Costa L, Barreto I, Asato M, Araujo K, Losada D, Herculiani A, Tabosa G, Zaidan B, Oliveira G, Bastos L, Rocha R. Genitourinary Malignancies in Transplant or Dialysis Patients: The Frequency of Two Newly Described 2016 World Health Organization Histopathologic Types. Transplant Proc 2017; 49:1783-1785. [DOI: 10.1016/j.transproceed.2017.06.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 05/18/2017] [Accepted: 06/01/2017] [Indexed: 11/27/2022]
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