Mucinous tubular and spindle cell carcinoma of kidney: Clinicopathology and prognosis.
- Author:
Qi SHEN
1
,
2
,
3
;
Yi Xiao LIU
1
,
2
,
3
;
Qun HE
1
,
2
,
3
Author Information
1. Department of Urology, Peking University First Hospital
2. Institute of Urology, Peking University
3. National Urological Cancer Center, Beijing 100034, China.
- Publication Type:Journal Article
- Keywords:
Clinical pathology;
Immunohistoche-mistry;
Mucinous adenocarcinoma;
Prognosis;
Renal cell carcinoma
- MeSH:
Humans;
Male;
Female;
Middle Aged;
Kidney Neoplasms/surgery*;
Carcinoma, Renal Cell/diagnosis*;
In Situ Hybridization, Fluorescence;
Retrospective Studies;
Adenocarcinoma, Mucinous/pathology*;
Kidney/pathology*;
Prognosis;
Necrosis
- From:
Journal of Peking University(Health Sciences)
2023;55(2):276-282
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate and summarize the clinicopathological features, immunophenotype, differential diagnosis and prognosis analysis of mucinous tubular and spindle cell carcinoma (MTSCC).
METHODS:The data of thirteen cases of MTSCC were retrospectively analyzed, the clinical and pathological characteristics and immunohistochemical expression were summarized, and fluorescence in situ hybridization was detected.
RESULTS:Among the thirteen patients, four were males and nine females, with a male-to-female ratio of 1 ∶2.25. The average age was 57.1 years, ranging from 39 to 78 years. The maximum diameter of the tumor was 2-12 cm. All cases had no symptoms, and were accidentally discovered, 3 cases underwent partial renal resection, 10 cases underwent radical renal resection, 9 cases were located in the left kidney, and 4 cases were located in the right kidney. Most of the cases showed the classical morphological changes, with 11 cases of nuclear grading [World Health Organization (WHO)/International Society of Urological Pathology (ISUP) grading system] being G2 and 2 cases being G3. There were 6 cases of stage PT1a, 3 cases of PT1b, 2 cases of PT2a, and 1 case of PT2b and 1 case of PT3a. The positive rates of immunohistochemical staining were: vimentin, AE1/AE3, α-methylacyl-CoA racemase (αMACR) and cytokeratin (CK) 8/18, 100% (13/13); CK7, 92.3% (12/13); epithelial membrane antigen (EMA), 92.3% (12/13); CK20, 46.2% (6/13); CD10, 30.8% (4/13); synaptophysin (Syn), 7.7% (1/13); chromogranin A (CgA), CD57, WT1 and Ki-67, 0 (0/13), and fluorescence in situ hybridization showed that no trisomy of chromosomes 7 and 17 were observed in any of the cases. The follow-up period was 6 months to 7 years and 6 months, 2 cases died after lung metastasis (one with ISUP/WHO grade G3, one with necrosis), and the remaining 11 cases had no recurrence and metastasis.
CONCLUSION:MTSCC is a unique type of low-grade malignancy kidney tumor, occurs predominantly in females, widely distributed in age, the current treatment method is surgical resection, and cases with necrosis and high-grade morphology are prone to recurrence and metastasis, although most cases have a good prognosis, but they still need close follow-up after surgery.