Kim Bohyun, Kim Han-Seong, Moon Kyung Chul
Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Pathology, Inje University College of Medicine, Goyang, Republic of Korea.
Diagn Pathol. 2019 Feb 7;14(1):12. doi: 10.1186/s13000-019-0791-7.
Primary renal well-differentiated neuroendocrine tumors (WDNETs) also called carcinoid and atypical carcinoid are extremely rare, and little is known about parameters that may predict prognosis at diagnosis.
Six cases of primary renal WDNET were collected. After reviewing slides stained with hematoxylin and eosin, proportions of each growth pattern were determined. Synaptophysin, chromogranin, CD56, and Ki-67 immunostaining and Ki-67 morphometric analysis were performed.
Patients included three female and three males, mean age was 53.3 years. The mean tumor size was 4.5 cm, three cases were greater than 5 cm. At the time of initial surgery, lymph node and/or distant metastasis was confirmed in two cases. In a third case, no metastasis was initially found, but lymph node metastasis was identified during follow-up. The remaining three cases did not exhibit metastasis. Histopathologically, the renal WDNETs were primarily composed of ribbon-like and sheet-like growth patterns. Most of the tumors were diffusely positive for neuroendocrine markers. Mitotic count was high (≥2/10HPF) in cases with lymph node or distant metastasis but was low (< 2/10HPF) in non-metastatic cases. Furthermore, the Ki-67 index was also higher (≥3%) in the cases with metastases than in cases without metastasis.
Three out of the six primary renal WDNETs demonstrated aggressive behavior and exhibited increased mitotic counts and Ki-67 indices. These results suggest that mitosis and the Ki-67 index could be used as prognostic indicators for renal WDNET.
原发性肾高分化神经内分泌肿瘤（WDNETs），也称为类癌和非典型类癌，极为罕见，对于诊断时可能预测预后的参数知之甚少。
收集6例原发性肾WDNETs病例。在复查苏木精和伊红染色切片后，确定每种生长模式的比例。进行突触素、嗜铬粒蛋白、CD56和Ki-67免疫染色以及Ki-67形态计量分析。
患者包括3名女性和3名男性，平均年龄为53.3岁。肿瘤平均大小为4.5厘米，3例大于5厘米。初次手术时，2例证实有淋巴结和/或远处转移。第3例最初未发现转移，但随访期间发现有淋巴结转移。其余3例未出现转移。组织病理学上，肾WDNETs主要由带状和片状生长模式组成。大多数肿瘤神经内分泌标志物弥漫性阳性。有淋巴结或远处转移的病例有丝分裂计数高（≥2/10高倍视野），而无转移病例则低（<2/10高倍视野）。此外，有转移病例的Ki-67指数也高于无转移病例（≥3%）。
6例原发性肾WDNETs中有3例表现出侵袭性，有丝分裂计数和Ki-67指数增加。这些结果表明，有丝分裂和Ki-67指数可作为肾WDNET的预后指标。
