Pini Giacomo Maria, Lucianò Roberta, Colecchia Maurizio
Department of Pathology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy.
Cancers (Basel). 2023 Jun 26;15(13):3352. doi: 10.3390/cancers15133352.
A wide variety of renal neoplasms can have cystic areas. These can occur for different reasons: some tumors have an intrinsic cystic architecture, while others exhibit pseudocystic degeneration of necrotic foci or they have cystically dilated renal tubules constrained by stromal neoplastic cells. Clear cell renal cell carcinoma (CCRCC), either solid or cystic, is the most frequent type of renal cancer. While pseudocysts are found in high-grade aggressive CCRCC, cystic growth is associated with low-grade indolent cases. The latter also form through a cyst-dependent molecular pathway, and they are more frequent in patients suffering from VHL disease. The differential diagnosis of multilocular cystic renal neoplasm of low malignant potential and clear cell papillary renal cell tumor can be especially hard and requires a focused macroscopical and microscopical pathological analysis. As every class of renal tumor includes cystic forms, knowledge of the criteria required for a differential diagnosis is mandatory.
多种肾肿瘤可出现囊性区域。其发生原因各不相同：一些肿瘤具有固有的囊性结构，而另一些则表现为坏死灶的假囊性退变，或者它们有被间质肿瘤细胞限制的囊性扩张肾小管。透明细胞肾细胞癌（CCRCC），无论是实性还是囊性，都是最常见的肾癌类型。虽然在高级别侵袭性CCRCC中可发现假囊肿，但囊性生长与低级别惰性病例相关。后者也通过依赖囊肿的分子途径形成，并且在患有VHL病的患者中更常见。低恶性潜能多房性囊性肾肿瘤与透明细胞乳头状肾细胞肿瘤的鉴别诊断可能特别困难，需要进行有针对性的宏观和微观病理分析。由于每一类肾肿瘤都包括囊性形式，因此掌握鉴别诊断所需的标准是必不可少的。
