Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi 780-8562, Japan.
Ann Diagn Pathol. 2011 Dec;15(6):462-6. doi: 10.1016/j.anndiagpath.2010.07.008. Epub 2010 Oct 30.
Acquired cystic disease (ACD)-associated renal cell carcinoma (RCC) is a recently described entity. To the best of our knowledge, there are no reports of ACD-associated RCC with sarcomatoid and rhabdoid changes. In this article, we present the first case of such a tumor. A 56-year-old Japanese man has received long-term hemodialysis and had a history of right renal cancer. Following the discovery of metastatic cancer in the thoracic wall, detailed imaging studies revealed a mass in the left kidney. The histologic examination of the left renal tumor showed ACD-associated RCC with sarcomatoid change and rhabdoid features. Immunohistochemically, intracytoplasmic globular inclusions in rhabdoid cells were positive for vimentin and cytokeratin CAM5.2. The G-band karyotype showed the following changes: 46, X, +X. -Y[1]/43, idem, add(2)(q31), -6, -9, -14, -15, +16, -22, +mar1[6]/46, XY[2]/abnormal cell[11]. In conclusion, pathologists and urologists should be aware that rhabdoid features may occur in ACD-associated RCC and that the loss of chromosomes 9 and 14 may occur during the process of sarcomatoid change in ACD-associated RCC.
获得性囊性疾病（ACD）相关肾细胞癌（RCC）是一种新近描述的实体。据我们所知，尚无伴有肉瘤样和横纹肌样改变的 ACD 相关 RCC 的报道。本文报道了首例此类肿瘤。一名 56 岁的日本男性接受长期血液透析，并有右肾癌病史。在发现胸壁转移性癌症后，详细的影像学研究显示左肾有一个肿块。左肾肿瘤的组织学检查显示伴有肉瘤样改变和横纹肌样特征的 ACD 相关 RCC。免疫组化显示，横纹肌样细胞的细胞质内包涵体呈波形蛋白和细胞角蛋白 CAM5.2 阳性。G 带核型显示以下变化：46，X，+X。-Y[1]/43，idem，add(2)(q31)，-6，-9，-14，-15，+16，-22，+mar1[6]/46，XY[2]/异常细胞[11]。总之，病理学家和泌尿科医生应该意识到横纹肌样特征可能发生在 ACD 相关 RCC 中，并且在 ACD 相关 RCC 的肉瘤样改变过程中可能会丢失染色体 9 和 14。
