Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
Department of Pathology and Laboratory Medicine, Brown University, Providence, Rhode Island.
Cancer Cytopathol. 2019 Jun;127(6):370-376. doi: 10.1002/cncy.22146. Epub 2019 May 15.
Papillary renal cell carcinoma (pRCC) is classified as type 1 or type 2 on the basis of histomorphologic features. Type 1 pRCC typically carries a better prognosis, and renal cell carcinoma is often diagnosed by fine-needle aspiration (FNA). Thus, this study was designed to characterize cytomorphologic features present in FNA cases that could be used to discriminate between type 1 and type 2 pRCC.
Electronic records of Indiana University were searched for pRCC FNA cases (2007-2018). Corresponding surgical pathology reports were reviewed to classify patients as having type 1 or type 2 pRCC. FNA slides were reviewed to assess cytomorphologic features (ie, nuclear grade; cell size; cytoplasmic volume and quality; and the presence of single cells, papillary clusters, nuclear grooves, foamy histiocytes, hemosiderin pigment, psammoma bodies, and hyaline globules). A semiquantitative score was assigned to each feature. The nuclear grade was assigned with the World Health Organization/International Society of Urological Pathology grading system. The cytomorphologic features of type 1 and type 2 pRCC were compared.
Sixteen patients with type 1 pRCC and 12 patients with type 2 pRCC were included in the study. Type 2 pRCC had a higher nuclear grade, a higher volume of cytoplasm, and more granular cytoplasm. Type 1 pRCC more frequently had nuclear grooves and clear cytoplasm. The remaining features (ie, cell size, papillary clusters, single cells, foamy histiocytes, hemosiderin pigment, psammoma bodies, and hyaline globules) were not statistically significant.
Nuclear grade, cytoplasmic volume and granularity or clarity, and nuclear grooves are cytomorphologic features that may aid in the distinction between type 1 and type 2 pRCC.
乳头状肾细胞癌（pRCC）根据组织形态学特征分为 1 型或 2 型。1 型 pRCC 通常预后较好，肾细胞癌通常通过细针抽吸（FNA）诊断。因此，本研究旨在描述 FNA 病例中存在的有助于区分 1 型和 2 型 pRCC 的细胞学特征。
检索印第安纳大学的电子病历，寻找 pRCC FNA 病例（2007-2018 年）。回顾相应的手术病理报告，将患者分类为 1 型或 2 型 pRCC。检查 FNA 切片以评估细胞学特征（即核级；细胞大小；细胞质体积和质量；以及单细胞、乳头状簇、核沟、泡沫状组织细胞、含铁血黄素色素、砂粒体和透明小体的存在）。为每个特征分配一个半定量评分。核级采用世界卫生组织/国际泌尿病理学会分级系统进行评估。比较 1 型和 2 型 pRCC 的细胞学特征。
研究纳入了 16 例 1 型 pRCC 患者和 12 例 2 型 pRCC 患者。2 型 pRCC 的核级较高，细胞质体积较大，细胞质较粗糙。1 型 pRCC 更常见核沟和透明细胞质。其余特征（即细胞大小、乳头状簇、单细胞、泡沫状组织细胞、含铁血黄素色素、砂粒体和透明小体）无统计学意义。
核级、细胞质体积和颗粒度或透明度、核沟是有助于区分 1 型和 2 型 pRCC 的细胞学特征。
