Qi J, Shen P U, Rezuke W N, Currier A A, Westfall P K, Mandavilli S R
Department of Pathology, Hartford Hospital, Connecticut 06102, USA.
Acta Cytol. 2001 Sep-Oct;45(5):735-9. doi: 10.1159/000328296.
Renal medullary carcinoma is a recently described, highly aggressive neoplasm that affects predominantly young African American males with a history of sickle cell trait. To the best of our knowledge, this is the first report of fine needle aspirate cytology (FNAC) findings of renal medullary carcinoma.
A 14-year-old, African American male with a history of sickle cell trait presented with the sudden onset of third cranial nerve palsy. Radiographic examination demonstrated possible tumor masses in the brain, thorax and left kidney. Ultrasound-guided fine needle aspiration was performed on the left kidney, and a cytologic diagnosis of "suspect renal medullary carcinoma" was rendered. The cytologic diagnosis was confirmed by tissue examination.
The cytologic features of renal medullary carcinoma include loosely cohesive clusters and single epithelioid cells with cytologic atypia, including high nuclear/cytoplasmic ratios, hyperchromasia, prominent nucleoli and cytoplasmic vacuolation. These cytologic findings, coupled with clinical findings (young black male with sickle cell trait), allow recognition of this rare renal neoplasm.
肾髓质癌是一种最近才被描述的高度侵袭性肿瘤，主要影响有镰状细胞性状病史的年轻非裔美国男性。据我们所知，这是首例关于肾髓质癌细针穿刺抽吸细胞学（FNAC）检查结果的报告。
一名14岁有镰状细胞性状病史的非裔美国男性，突然出现动眼神经麻痹。影像学检查显示脑、胸和左肾可能有肿瘤肿块。对左肾进行了超声引导下细针穿刺抽吸，细胞学诊断为“疑似肾髓质癌”。组织检查证实了细胞学诊断。
肾髓质癌的细胞学特征包括松散聚集的细胞团和单个具有细胞学异型性的上皮样细胞，包括高核质比、核深染、核仁突出和细胞质空泡化。这些细胞学表现，结合临床特征（有镰状细胞性状的年轻黑人男性），有助于识别这种罕见的肾脏肿瘤。
