Hes Ondrej, Brunelli Matteo, Michal Michal, Cossu Rocca Paolo, Hora Milan, Chilosi Marco, Mina Michaela, Boudova Ludmila, Menestrina Fabio, Martignoni Guido
Department of Special Diagnostics SPAU, University Hospital Plzen, Czech Republic.
Ann Diagn Pathol. 2006 Jun;10(3):133-9. doi: 10.1016/j.anndiagpath.2005.12.002.
Papillary renal cell carcinoma (RCC) is subclassified in type 1 displaying cells with scanty pale cytoplasm arranged in a single layer and in type 2 showing pseudostratified cells with eosinophilic cytoplasm. However, the existence of more variants of papillary RCC may be inferred by the recognition of few cases with different morphological features. We report the clinicopathologic, immunohistochemical, ultrastructural, and interphase cytogenetic features of 12 papillary RCC composed by oncocytes. Ten patients were males and their median age was 67 years. The tumors were well demarcated and their median diameter was 7.1 cm. Solid oncocytoma-like areas occurred in 11 cases. The cytoplasm of the neoplastic cells was filled by mitochondria with lamellar cristae. All cases were positive for the antimitochondrial antigen and racemase and showed variable immunoreactivity for cytokeratins (AE1/AE3, CK8-18, CK7, CK19), EMA, CD10, vimentin, and parvalbumin. MIB1 was detected in 0 to 6 cells per 1 high-power field. Fluorescent in situ hybridization analysis on formalin-fixed paraffin-embedded tissue showed three or more signals for chromosome 7 and 17 (for both > or =30% of nuclei in 7 of 12 neoplasms). In males, signals of chromosome Y were absent in more than 80% of the neoplastic nuclei. One patient died of metastases. Interphase cytogenetic analysis by fluorescent in situ hybridization can be a diagnostic tool in cases mimicking an oncocytoma.
乳头状肾细胞癌（RCC）可分为1型，其细胞单层排列，胞质淡染稀少；2型则显示假复层细胞，胞质嗜酸性。然而，通过识别少数具有不同形态特征的病例，可以推断乳头状RCC可能存在更多变体。我们报告了12例由嗜酸性细胞瘤构成的乳头状RCC的临床病理、免疫组化、超微结构和间期细胞遗传学特征。10例患者为男性，中位年龄67岁。肿瘤边界清晰，中位直径7.1 cm。11例出现实性嗜酸性细胞瘤样区域。肿瘤细胞的胞质内充满了具有板层嵴的线粒体。所有病例抗线粒体抗原和消旋酶均呈阳性，细胞角蛋白（AE1/AE3、CK8 - 18、CK7、CK19）、EMA、CD10、波形蛋白和小白蛋白显示出不同程度的免疫反应性。每高倍视野中MIB1在0至6个细胞中被检测到。对福尔马林固定石蜡包埋组织进行荧光原位杂交分析显示，12例肿瘤中有7例7号和17号染色体有三个或更多信号（两者均≥3 nuclei的30%）。在男性中，超过80%的肿瘤细胞核中不存在Y染色体信号。1例患者死于转移。荧光原位杂交进行的间期细胞遗传学分析可作为诊断类似嗜酸性细胞瘤病例的工具。
