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易位癌:一种在成人中也存在的儿童肾肿瘤

[The translocation carcinoma: A pediatric renal tumor also in adults].

作者信息

Bruder E, Moch H

机构信息

Institut für Pathologie, Universitätsspital Basel, Schönbeinstrasse 40, Basel, Schweiz.

Institut für Klinische Pathologie, Universitätsspital Zürich, Zürich, Schweiz.

出版信息

Pathologe. 2016 Mar;37(2):159-65. doi: 10.1007/s00292-016-0151-2.

Abstract

The MiT family of translocation-associated renal cell carcinomas comprise approximately 40 % of renal cell carcinomas in young patients but only up to 4 % of renal cell carcinomas in adult patients. The Xp11.2 translocation-associated tumors are the most frequent and were included in the 2004 World Health Organization (WHO) classification. They contain a fusion of the TFE3 gene with ASPSCR1, PRCC, NONO, SPFQ or CLTC resulting in an immunohistochemically detectable nuclear overexpression of TFE3. The Xp11.2 translocation-associated renal cell carcinomas are characterized by ample clear cytoplasm, papillary architecture and abundant psammoma bodies. The TFEB translocation-associated renal cell carcinomas are much rarer and show a biphasic architecture. Fluorescence in situ hybridization permits the detection of a translocation by means of a break apart probe for the TFE3 and TFEB genes and is recommended for the diagnosis of renal cell carcinomas in patients under 30 years of age. The TFE3 and TFEB translocation-associated tumors are classified as MiT family translocation carcinomas in the new WHO classification.The rare renal cell carcinomas harboring an ALK rearrangement with fusion to VCL in young patients with sickle cell trait show a characteristic morphology and are listed in the new WHO classification as a provisional entity.

摘要

与易位相关的肾细胞癌的MiT家族在年轻患者的肾细胞癌中约占40%,但在成年患者的肾细胞癌中仅占4%。Xp11.2易位相关肿瘤最为常见,并被纳入2004年世界卫生组织(WHO)分类。它们包含TFE3基因与ASPSCR1、PRCC、NONO、SPFQ或CLTC的融合,导致TFE3在免疫组织化学上可检测到核过表达。Xp11.2易位相关肾细胞癌的特征是丰富的透明细胞质、乳头结构和大量砂粒体。TFEB易位相关肾细胞癌更为罕见,表现为双相结构。荧光原位杂交可通过TFE3和TFEB基因的分离探针检测易位,推荐用于30岁以下患者肾细胞癌的诊断。在新的WHO分类中,TFE3和TFEB易位相关肿瘤被归类为MiT家族易位癌。在患有镰状细胞性状的年轻患者中,罕见的具有与VCL融合的ALK重排的肾细胞癌表现出特征性形态,并在新的WHO分类中作为一个暂定实体列出。

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