Park Jeong Hwan, Lee Cheol, Suh Ja Hee, Moon Kyung Chul
Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
Korean J Pathol. 2012 Dec;46(6):541-7. doi: 10.4132/KoreanJPathol.2012.46.6.541. Epub 2012 Dec 26.
Clear cell papillary renal cell carcinoma (CCPRCC) is a recently established subtype of renal epithelial tumor. The aim of this study was to identify the diagnostic criteria of CCPRCC with an emphasis on immunohistochemical studies, and to report three cases with concurrent other-type renal cell carcinoma (RCC).
A total of 515 RCC patients that consecutively underwent surgical resection at Seoul National University Hospital from 1 January 2010 to 31 December 2011 were screened. Each case was reviewed based on the histologic features and was evaluated immunohistochemically.
A total of 15 CCPRCCs were identified, which composed 2.9% of the total RCCs. The mean age was 52 years, and the average tumor size was 1.65 cm. All 15 cases showed low nuclear grade, no lymph node metastasis and no distant metastasis. The CCPRCCs showed variable architectural patterns including cystic, trabecular, papillary, and acinar. All of the cases showed moderate to intense immunoreactivity for cytokeratin 7 (CK7). CD10 was negative or showed focal weak positivity. Three cases had concurrent other-type RCC, including a clear cell RCC and an acquired cystic disease-associated RCC.
The strong CK7 and negative or focal weak CD10 expression will be useful for the diagnosis of CCPRCC.
透明细胞乳头状肾细胞癌(CCPRCC)是一种最近确立的肾上皮肿瘤亚型。本研究的目的是确定CCPRCC的诊断标准,重点是免疫组织化学研究,并报告3例合并其他类型肾细胞癌(RCC)的病例。
对2010年1月1日至2011年12月31日在首尔国立大学医院连续接受手术切除的515例RCC患者进行筛查。根据组织学特征对每个病例进行复查,并进行免疫组织化学评估。
共鉴定出15例CCPRCC,占RCC总数的2.9%。平均年龄为52岁,平均肿瘤大小为1.65 cm。所有15例均显示低核分级,无淋巴结转移和远处转移。CCPRCC表现出多种结构模式,包括囊性、小梁状、乳头状和腺泡状。所有病例对细胞角蛋白7(CK7)均表现为中度至强免疫反应性。CD10阴性或呈局灶性弱阳性。3例合并其他类型RCC,包括1例透明细胞RCC和1例获得性囊性疾病相关性RCC。
强CK7表达及CD10阴性或局灶性弱阳性对CCPRCC的诊断有帮助。