Lee Cheol, Park Jeong-Whan, Suh Ja Hee, Nam Kyung Han, Moon Kyung Chul
Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
Korean J Pathol. 2013 Oct;47(5):426-32. doi: 10.4132/KoreanJPathol.2013.47.5.426. Epub 2013 Oct 25.
Due to advancements in treatment of metastatic and advanced renal cell carcinoma (RCC), it has become increasingly important to diagnose metastatic RCC and the specific subtype. In this study, we investigated the diverse histologic features of metastatic clear cell renal cell carcinoma (CCRCC) cases in comparison with corresponding primary lesions.
We identified 119 metastatic CCRCC cases from 81 corresponding primary lesions diagnosed between 1995 and 2010 and evaluated the diverse histologic and immunohistochemical features of these lesions.
A total of 44 primary lesions (54.3%) had a non-clear cell component in addition to a typical clear cell component. Of the 119 metastatic lesions, 63 lesions (52.9%) contained a non-clear cell component, and 29 metastatic lesions were composed of a non-clear cell component only. Rhabdoid features were the most frequent non-clear cell histology among the metastatic lesions. Metastatic CCRCCs mainly showed positive CD10 and epithelial membrane antigen staining and negative cytokeratin 7 staining.
Metastatic CCRCC commonly showed a variety of histologic features. If there is a difficulty to diagnose metastatic CCRCC due to a variety of histologic features or small biopsy specimen, histologic review of the primary lesion and immunohistochemical analysis can help determine the correct diagnosis.
由于转移性和晚期肾细胞癌（RCC）治疗方法的进步，诊断转移性RCC及其特定亚型变得越来越重要。在本研究中，我们调查了转移性透明细胞肾细胞癌（CCRCC）病例与相应原发灶相比的多种组织学特征。
我们从1995年至2010年诊断的81个相应原发灶中确定了119例转移性CCRCC病例，并评估了这些病变的多种组织学和免疫组化特征。
共有44个原发灶（54.3%）除典型透明细胞成分外还具有非透明细胞成分。在119个转移灶中，63个病灶（52.9%）含有非透明细胞成分，29个转移灶仅由非透明细胞成分组成。横纹肌样特征是转移灶中最常见的非透明细胞组织学类型。转移性CCRCC主要表现为CD10和上皮膜抗原染色阳性，细胞角蛋白7染色阴性。
转移性CCRCC通常表现出多种组织学特征。如果由于多种组织学特征或活检标本较小而难以诊断转移性CCRCC，对原发灶进行组织学复查和免疫组化分析有助于确定正确诊断。
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