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Prípad SD IAP č. 262

Detailed clinical case study of a 76-year-old man with a kidney tumor, including histological findings, immunohistochemistry results, genetics, histogenesis, differential diagnosis, and relevant literature references.

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Prípad SD IAP č. 262

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  1. Prípad SD IAP č. 262

  2. Klinické údaje: • 76-ročný muž sledovaný pre tumor močového mechúra, na CT zachytený tumor pravej obličky priemeru 4 cm • makro: sivočervený, dobre ohraničený, s drobnými dutinkami, subkapsulárny

  3. CK 7 RCC EMA Vimentin

  4. Racemáza P504S

  5. Imunohistochémia • pozit.: EMA, M903, Vimentin (fokálne)P504S, AE 1/3 • negat.: CD-10, RCC, SMA, Dezmín, HMB-45, CEA, CK7

  6. Mucinous tubular and spindle cell carcinoma.

  7. História • Ordonez (1996), Loreta (1998), He (1998), Otani (2001) – neklasifikovaný • Parwani (2001) – LG myxoid renal epithelial neoplasm • Hes (2002), Razoky (2002) • WHO 2004

  8. LG polymorfný renálny tumor: mucinózny, tubulárny, spindle cell • 17 – 82 rokov • M / Ž – 1 / 4 • v minulosti: neklasifikovaný alebo sarkomatoidný

  9. Genetika • WHO • losses: 1,4,6,8,13,14 • gains: 7,11,16,17 • ???

  10. Histogenéza • distálny nefrón, Henleho kľučka • proximálny nefrón, vzťah k papilárnemu Ca • ?

  11. Dif. dg. • metanefrický adenóm • onkocytóm • LG Bellini • konvenčný RCC • papilárny RCC • sarkomatoidný RCC • juxtaglomerular cell tumor • angiomyolipóm

  12. Použitá literatúra • WHO 2004 • Expanding the Histologic Spectrum of Mucinous Tubular and Spindle Cell Carcinoma of the Kidney. Samson W. Fine, MD; Pedram Argani, MD; Angelo M. DeMarzo, MD, PhD; Brett Delahunt, MD; Thomas J. Sebo, MD; Victor E. Reuter, MD; Jonathan I. Epstein, MD, American Journal of Surgical Pathology. 30(12):1554-1560, December 2006. • Review of mucinous tubular and spindle-cell carcinoma of the kidney with a focus on clinical and pathobiological aspects, N. Kuroda, M. Toi1, M. Hiroi, T. Shuin and H. Enzan, Histopathol 20, 221-224 (2005) • Low-grade myxoid renal epithelial neoplasms with distal nephron differentiation, A. Parwani, Human Pathology, Volume 32, Issue 5, Pages 506-512 • Mucinous tubular and spindle cell carcinoma of kidney is probably a variant of papillary renal cell carcinoma with spindle cell features. Shen SS, Ro JY, Tamboli P, Truong LD, Zhai Q, Jung SJ, Tibbs RG, Ordonez NG, Ayala AG, Annals of diagnostic pathology 11 (2007) 13 - 21

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