Caraballo Beatriz, Abdulla Maha, Sham Sunder, Xiao Guang-Qian, Unger Pamela
Pathology and Laboratory Medicine, Lenox Hill Hospital, New York City, USA.
Department of Pathology, Lenox Hill Hospital, Northwell Health, New York City, USA.
Cureus. 2022 May 12;14(5):e24944. doi: 10.7759/cureus.24944. eCollection 2022 May.
Papillary renal cell carcinoma (PRCC) with micropapillary carcinoma (MC) has been rarely described. We conducted a retrospective descriptive evaluation of the association of MC with PRCC and the possible prognostic implications.
A database search was made at the University of Southern California (USC) and Lenox Hill Hospital (LHH; New York City) in June 2016-June 2019 of PRCC cases with MC. Diagnosis of MC was made using routine histology, based on the presence of small clusters of cells without a vascular core. Features evaluated included: percent of MC, gross appearance, PRCC typing, nuclear grade, lymphovascular invasion, and lymph node metastasis.
848 RCC cases (690 from USC and 157 from LHH); 70 cases PRCC (54 from USC, 16 from LHH) of these cases, 13 had an MC, 12 were from radical nephrectomy, and 12 cases were male. Mean age was 68.3 years; seven were located in the right kidney. Average tumor size was 8.6 cm. MC ranged from 10% to 80% (average 37.5%), nine cases were PRCC type 2 and four type 1. Nuclear grade: three cases (grade 2), nine cases (grade 3), and one case (grade 4); 11 out of 13 tumors presented with extrarenal extension; nine cases that had lymph nodes submitted had metastatic carcinoma.
The presence of a micropapillary component in PRCC was found to be 18.5%, and it was predominantly associated with high pathologic stage and lymph node metastases. The clinical course of these tumors seems similar to MC in other tissues/organ systems. We advocate reporting this pattern when identified.
关于伴有微乳头癌（MC）的乳头状肾细胞癌（PRCC）的报道很少。我们对MC与PRCC的关联及其可能的预后意义进行了回顾性描述性评估。
2016年6月至2019年6月在南加州大学（USC）和莱诺克斯山医院（LHH；纽约市）对伴有MC的PRCC病例进行数据库检索。MC的诊断采用常规组织学方法，基于存在无血管核心的小细胞簇。评估的特征包括：MC的百分比、大体外观、PRCC分型、核分级、淋巴管侵犯和淋巴结转移。
共848例肾细胞癌病例（690例来自USC，157例来自LHH）；其中70例PRCC（54例来自USC，16例来自LHH），这些病例中13例伴有MC，12例来自根治性肾切除术，12例为男性。平均年龄为68.3岁；7例位于右肾。平均肿瘤大小为8.6 cm。MC占比范围为10%至80%（平均37.5%），9例为PRCC 2型，4例为1型。核分级：3例（2级），9例（3级），1例（4级）；13例肿瘤中有11例出现肾外扩展；9例有送检淋巴结的病例存在转移癌。
发现PRCC中微乳头成分的占比为18.5%，且主要与高病理分期和淋巴结转移相关。这些肿瘤的临床病程似乎与其他组织/器官系统中的MC相似。我们主张在识别出这种模式时进行报告。
