Khurana K K, Powers C N
Department of Pathology, State University of New York Health Science Center, University Hospital, Syracuse 13210, USA.
Diagn Cytopathol. 1997 Nov;17(5):379-82. doi: 10.1002/(sici)1097-0339(199711)17:5<379::aid-dc12>3.0.co;2-k.
We describe an unusual case of a basaloid squamous-cell carcinoma (BSCC) of the tonsil in a 56-yr-old man that metastasized to a primary renal-cell carcinoma (RCC) and the lung. The diagnosis of the second primary, the RCC, was based on fine-needle aspiration (FNA) cytology. A subsequent nephrectomy specimen revealed BSCC metastatic to RCC, clear-cell type. Retrospective analysis of the FNA of the renal mass revealed classic RCC morphology and, in addition, another cytologically distinctive pattern characterized by occasional sheets of cohesive neoplastic cells with hyperchromatic nuclei and nuclear molding representative of BSCC. The cytologic features of a subsequent FNA of the lung were characteristic of metastatic BSCC. Our retrospective analysis of cytologic material from the renal mass underscores the importance of raising the possibility of tumor-to-tumor metastasis when distinctly different morphologic features are seen in an otherwise typical cytology of a neoplasm in patients with an already known or suspected second primary. To our knowledge, this case report is the first one documenting metastasis of BSCC to RCC.
我们描述了一例罕见病例，一名56岁男性扁桃体基底样鳞状细胞癌（BSCC）转移至原发性肾细胞癌（RCC）和肺部。第二原发性肿瘤RCC的诊断基于细针穿刺（FNA）细胞学检查。随后的肾切除标本显示为BSCC转移至RCC，透明细胞型。对肾肿块FNA的回顾性分析显示出典型的RCC形态，此外，还有另一种细胞学上独特的模式，其特征为偶尔出现成片的相互黏附的肿瘤细胞，细胞核深染且有核膜内陷，这是BSCC的表现。随后对肺部进行FNA的细胞学特征为转移性BSCC。我们对肾肿块细胞学材料的回顾性分析强调，在已知或疑似患有第二原发性肿瘤的患者中，当在肿瘤的典型细胞学检查中发现明显不同的形态特征时，提高肿瘤间转移可能性的重要性。据我们所知，本病例报告是首例记录BSCC转移至RCC的病例。
