Harich Octavia Oana, Olteanu Gheorghe-Emilian, Mihai Ioana Maria, Benta Marius, Isabella Gavriliuc Oana, Virgil Paunescu, Bojin Florina Maria
Department of Functional Sciences, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania.
Department of Infectious Diseases, Discipline of Pulmonology, Center for Research and Innovation in Personalized Medicine of Respiratory Diseases, "Victor Babes" University of Medicine and Pharmacy, Timisoara Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania.
Diagnostics (Basel). 2022 Aug 6;12(8):1904. doi: 10.3390/diagnostics12081904.
Papillary renal cell carcinoma (PRCC) is defined by the WHO 2022 classification as a malignant tumor derived from the renal tubular epithelium. However, the WHO 2016 classification subdivided PRCC into two types, with type 1 PRCC showing papillae covered by a single layer of neoplastic cells, and type II PRCC, which can show multiple types of histologies and is more aggressive. The WHO 2022 classification eliminated the subcategorization of PRCC. Here, we present a histopathological case study with a 4-year follow-up diagnosed in 2018 as type I PRCC (WHO 2016) with intra-pyelocalyceal growth pattern in a 59-year-old male patient with a history of Type II diabetes mellitus, left-sided renal-ureteral lithiasis, and benign hypertrophy of the prostate. Microscopically the tumor was composed of small cuboidal cells with inconspicuous nucleoli, arranged on a single layer of tubulo-papillary cores, and scant, foamy macrophages. The tumor had a non-infiltrative, expansive pyelocalyceal growth pattern. Immunohistochemically (IHC), the tumor cells were CK7-intense and diffusely positive, and stained granular for AMACR. Next-generation sequencing (NGS) was performed for the tumor and the normal adjacent tissue for in-depth pathological characterization. To our knowledge, this is the first reported case where a PRCC displays this unique intra-pyelocalyceal growth pattern, mimicking a urothelial cell carcinoma of the renal pelvis system.
乳头状肾细胞癌（PRCC）在世界卫生组织（WHO）2022年分类中被定义为源自肾小管上皮的恶性肿瘤。然而，WHO 2016年分类将PRCC细分为两种类型，1型PRCC的乳头由单层肿瘤细胞覆盖，而II型PRCC可表现出多种组织学类型且侵袭性更强。WHO 2022年分类取消了PRCC的亚分类。在此，我们展示一例组织病理学病例研究，该病例于2018年确诊，随访4年，患者为一名59岁男性，有II型糖尿病、左侧肾输尿管结石和前列腺良性增生病史，诊断为1型PRCC（WHO 2016），具有肾盂肾盏内生长模式。显微镜下，肿瘤由小立方形细胞组成，核仁不明显，排列在单层肾小管乳头核心上，并有少量泡沫状巨噬细胞。肿瘤具有非浸润性、扩张性肾盂肾盏生长模式。免疫组织化学（IHC）检查显示，肿瘤细胞CK7呈强阳性且弥漫性阳性，AMACR呈颗粒状染色。对肿瘤及相邻正常组织进行了二代测序（NGS）以进行深入的病理特征分析。据我们所知，这是首例报道的PRCC呈现这种独特的肾盂肾盏内生长模式，酷似肾盂系统的尿路上皮细胞癌的病例。
