Atypical epithelial proliferations in acquired renal cystic disease harbor cytogenetic aberrations.
ABSTRACT Acquired renal cystic disease (ARCD) complicating end-stage renal failure confers an increased risk for renal cell carcinoma, and atypical epithelial proliferation in the cysts may represent the precursor lesion. In this report we used an interphase cytogenetic technique to analyze the karyotypic features of various forms of atypical epithelial proliferations in a patient with ARCD. Both kidneys harbored numerous simple and atypical cysts. In addition, papillary tufts and a hitherto undescribed cribriform epithelial proliferation were found in the right kidney. The left kidney contained a 10-mm renal cell carcinoma with features indeterminate between clear cell and papillary types. There was gain of chromosome 7 in the papillary tufts; gain of chromosomes 7 and 17 in the cribriform lesion; gain of chromosomes 7, 12, 17, 20, and Y in the atypical cysts; and gain of chromosomes 7, 12, 17, and 20 in the renal cell carcinoma. These chromosomal aberrations suggest that atypical epithelial proliferations in ARCD represent early neoplastic lesions.
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ABSTRACT: The acquired cystic disease of the kidney-associated renal cell carcinoma (ACDK-RCC) in the current study occurred in a kidney with multiple cysts and was composed of cells with eosinophilic cytoplasm and prominent nucleoli. There were extensive calcium oxalate deposits in both non-neoplastic cysts and tumor. The tumor cells were positive for RCC Ma, CD10, and EMA, focally positive for CK7, negative for vimentin. Interphase in situ hybridizations (FISH) were performed for chromosome 1, 2, 7, 10, 13 and 17. No chromosomal abnormality was observed in the non-neoplastic cysts. Polysomies of chromosomes 1, 2, 7, 10, 13, 17 were observed in the tumor. Trisomy 13 was first reported in this type of tumor, which warranted further study.
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ABSTRACT: Patients with end-stage renal disease (ESRD) have an increased risk of developing renal cell carcinoma (RCC). This retrospective study compared clinical and pathological outcomes of RCC occurring in native kidneys of patients with ESRD (whether they underwent kidney transplantation or not) with those of renal tumors diagnosed in the general population. The study included a total of 533 patients with RCC. The ESRD cohort included 92 patients with RCC in native kidneys. Of these, 58 and 34 cases were identified before (pre-Tx group) and after kidney transplantation (post-Tx group), respectively. The control group was composed of 441 RCCs diagnosed in the general population. Variables were compared by chi-square and Student's t tests. Cancer-specific survival was assessed by Kaplan-Meier and Cox methods. The ESRD groups had smaller (P = 0.001), lower-grade, and lower-stage tumors than the non-ESRD group (P = 0.001). The papillary RCC rate was higher in the ESRD groups (P = 0.01). Ten-year cancer-specific survivals were 94.5, 87.9, and 74.6 % in pre-Tx, post-Tx, and non-ESRD patients, respectively (P = 0.003). Mean follow-up was 90.2 months. At multivariate analysis, tumor size (HR = 1.10), pathological stage (HR = 1.46), presence of nodal (HR = 2.22) and visceral metastases (HR = 3.49), and Fuhrman grade (HR = 1.48) were independent adverse prognostic factors for cancer-specific survival. Native kidney RCCs arising in ESRD patients are lower stage and lower grade as compared to RCCs diagnosed in the general population, and these tumors exhibit favorable clinical and outcome features.World Journal of Urology 02/2014; 33(1). DOI:10.1007/s00345-014-1248-y · 3.42 Impact Factor
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ABSTRACT: In this paper, we searched for the common histologic features characteristic of renal tumors in patients with Birt-Hogg-Dubé syndrome (BHDS). We selected six patients with histologically confirmed renal tumor in BHDS. Germline FLCN gene mutation has been identified in five patients. Multifocality and bilaterality of the renal tumors were pathologically or radiologically confirmed in five and two cases, respectively. Histological subtypes of the dominant tumor included three previously described hybrid oncocytic tumors, one composite chromophobe /papillary/clear cell RCC and one unclassified RCC resembling hybrid chromophobe/clear cell RCC. In one case, chromophobe RCC and clear cell RCC were separately observed. Small papillary lesions located in the peripheral area of the tumor, which we designated as intratumoral peripheral small papillary tuft (ITPSPT), were identified in all patients. In conclusion, multifocality/bilaterality of renal tumors, discordance of histologic subtypes and the presence of ITPSPT may be important clues to identify BHDS -associated renal tumors.Annals of diagnostic pathology 06/2014; DOI:10.1016/j.anndiagpath.2014.03.002 · 1.11 Impact Factor