Jung Soo Jin, Chung Jae Il, Park Sun Hwa, Ayala Alberto G, Ro Jae Y
Department of Pathology, Inje University College of Medicine, Busan, Korea.
Am J Surg Pathol. 2006 Mar;30(3):411-5. doi: 10.1097/01.pas.0000194745.10670.dd.
We present an unusual renal tumor, which has not been classified under a known subtype of renal cell carcinoma (RCC) and characteristically shows similar histology to thyroid follicular carcinoma. The patient was a 32-year-old asymptomatic woman who was found to have a kidney mass during her annual physical examination. She had no lesions in the thyroid during physical and ultrasound examinations, and there was no abnormal thyroid function test. Neither mediastinal nor ovarian abnormalities were observed. The resected kidney showed a well-defined nodular tumor measuring 11.8x8.0x8.0 cm. The mass was protruding into the pelvic cavity with areas of yellowish geographic necrosis. Histologically, the tumor showed follicular architectures with inspissated colloid-like material in their lumina. No conventional (clear cell) RCC or any other known subtypes of RCC component was observed. Immunohistochemically, the tumor cells showed intensive staining for cytokeratin (CK) cocktail AE1/AE3 and CD10 and were not reactive to thyroid transcription factor-1 and thyroglobulin. The staining of CK35betaH11 and vimentin revealed focal cytoplasmic reaction. The tumor cells were completely negative for CK7, CK19, CK20, CK34betaE12, carcinoembryonic antigen, epithelial membrane antigen, and CD15. Chromosomal gains of 7q36, 8q24, 12, 16, 17p11-q11, 17q24, 19q, 20q13, 21q22.3, and Xp and losses of 1p36, 3, and 9q21-33 were detected by comparative genomic hybridization. These findings are dissimilar to previously classified renal neoplasm. Only a report that included three cases of primary thyroid-like renal tumor has been described in the abstract form. However, there is no fully documented case on this unusual form of RCC, which morphologically resembles that of thyroid follicular carcinoma. Herein, we present a new case of thyroid follicular carcinoma-like tumor of the kidney with a chromosomal study and review of the literature.
我们报告一例罕见的肾肿瘤，该肿瘤不属于已知的肾细胞癌（RCC）亚型，其组织学特征与甲状腺滤泡癌相似。患者为一名32岁无症状女性，在年度体检时发现肾脏有肿块。体格检查和超声检查未发现甲状腺有病变，甲状腺功能检查也无异常。未观察到纵隔或卵巢有异常。切除的肾脏显示一个边界清晰的结节状肿瘤，大小为11.8×8.0×8.0 cm。肿块突入盆腔，有淡黄色地图状坏死区域。组织学上，肿瘤呈滤泡状结构，管腔内有浓缩的胶样物质。未观察到传统型（透明细胞）RCC或任何其他已知的RCC亚型成分。免疫组化显示，肿瘤细胞对细胞角蛋白（CK）混合抗体AE1/AE3和CD10呈强阳性染色，对甲状腺转录因子-1和甲状腺球蛋白无反应。CK35βH11和波形蛋白染色显示局灶性细胞质反应。肿瘤细胞对CK7、CK19、CK20、CK34βE12、癌胚抗原、上皮膜抗原和CD15完全阴性。通过比较基因组杂交检测到7q36、8q24、12、16、17p11-q11、17q24、19q、20q13、21q22.3和Xp染色体增加，以及1p36、3和9q21-33染色体缺失。这些发现与先前分类的肾肿瘤不同。仅有一篇摘要形式的报告描述了3例原发性甲状腺样肾肿瘤。然而，对于这种形态学上类似于甲状腺滤泡癌的不寻常形式的RCC，尚无完整记录的病例。在此，我们报告一例肾甲状腺滤泡癌样肿瘤的新病例，并进行染色体研究及文献复习。
