Cossu-Rocca P, Eble JN, Delahunt B, et al..Renal mucinous tubular and spindle carcinoma lacks the gains of chromosomes 7 and 17 and losses of chromosome Y that are prevalent in papillary renal cell carcinoma

Department of Pathology, Indiana University Medical Center, University Hospital, Indianapolis, IN 46202, USA.
Modern Pathology (Impact Factor: 6.19). 05/2006; 19(4):488-93. DOI: 10.1038/modpathol.3800565
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Mucinous tubular and spindle cell carcinoma of the kidney is an uncommon, distinctive neoplasm characterized by the proliferation of cuboidal and spindle cells arranged in tubular or sheet-like arrays, typically with a mucinous or myxoid background. The most important differential diagnostic consideration of mucinous tubular and spindle cell carcinoma is papillary renal cell carcinoma, type 1, with sarcomatoid transformation. The aim of our study is to investigate the pattern of possible gains or losses of chromosomes 7, 17 and Y in 10 mucinous tubular and spindle cell carcinomas with interphase fluorescence in situ hybridization (FISH). Four-micron sections were obtained from paraffin blocks representative of the tumors and including adjacent non-neoplastic renal parenchyma from 10 patients. The patients' ages ranged from 20 to 80 years (mean: 62 years); eight were female, while two were male. FISH analysis was performed with centromeric probes for chromosomes 7, 17 and Y. One hundred fifty to 200 nuclei from each case were scored for hybridization signals and non-neoplastic parenchyma served as control tissue. We found that renal mucinous tubular and spindle carcinoma lacks the gains of chromosomes 7 and 17 and losses of chromosome Y that are typical of papillary renal cell carcinoma. FISH analysis with centromeric probes for these chromosomes is potentially helpful in differentiating mucinous tubular and spindle cell carcinomas from papillary renal cell carcinomas.

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Available from: Shaobo Zhang, Apr 28, 2014
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    • "The classic MTSCC is a renal neoplasm characterized by small, elongated tubules lined by cuboidal cells and/or cords of spindle cells separated by pale mucinous stroma [2,4–7,9–13,15]. Non-classic morphologic variants have rarely been reported [4] [5]. We present a challenging case of MTSCC mimicking papillary renal cell carcinoma (RCC) and describe its histologic, immunohistochemical, ultrastructural, and fluorescence in situ hybridization (FISH) fea- tures. "
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    ABSTRACT: Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare type of kidney tumor with relatively indolent behavior. Non-classic morphological variants have not been well studied and rarely been reported. We report a challenging case MTSCC with a peculiar morphology in a 42-year-old man, arising in a background of end-stage renal disease (ESRD). Predominant areas with extensive papillary architecture, psammoma bodies and stromal macrophageal aggregates, reminiscent of a papillary renal cell carcinoma (papillary RCC), were intermixed with foci that transitioned into a MTSCC-like morphology exhibiting elongated tubules and a low grade spindle cell component in a background of mucinous stroma. Immunuhostochemistry demonstrated diffuse positivity for P504s/AMACR and vimentin in tumor cells. Focal positivity for RCC, CD10 and CK7 was also noted. Kidney-specific cadherin, cytokeratin 34betaE12 and TFE3 stains were negative in the tumor. The major differential diagnostic considerations were papillary RCC, clear cell papillary RCC, and Xp11.2 translocation carcinoma. Negative FISH studies for trisomy 7 and 17 in both papillary and spindled components supported the diagnosis of MTSCC. The ultrastructrural profile was not entirely indicative of the cellular origin of the tumor. Cytogenetic analysis should be performed in atypical cases of MTSCC for precise diagnosis.
    Pathology - Research and Practice 07/2014; 210(7). DOI:10.1016/j.prp.2014.03.002 · 1.40 Impact Factor
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    • "In addition, MTSCC-K lack the gains of chromosomes 7 and 17 and losses of chromosome Y which are typical of papillary RCC [12], and using fluorescence in situ hybridization with centromeric probes for these chromosomes is helpful in differentiating papillary RCC from MTSCC-K. Besides, as Behnes et al. [13] reported, N-cadherin can be used to differentiate subtypes of papillary RCC and it might be a potential marker for differentiating MTSCC-K and papillary RCC. "
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    ABSTRACT: Mucinous tubular and spindle cell carcinoma of kidney (MTSCC-K) is a rare variant of renal tumor. The current data show most of MTSCCs are of low malignant potential and rare cases metastatic to lymph nodes have been reported; however, the recorded computed tomography (CT) and follow up data are limited.Material and method: In the present study, we retrospectively analyzed CT and clinicopathological data of eight patients with renal MTSCC-K. A total of eight cases, including six females and two males, were included in this analysis with a mean age of 48.4 (range 25 to 81) years. Mean tumor size was 4.2 (range 2.5 to 10.0) cm. Preoperative CT demonstrated that all tumors were slightly enhanced on both corticomedullary and nephrographic phase, which was different from many other renal cell carcinomas. Three of them were treated with open radical nephrectomy, three with laparoscopic radical nephrectomy and the other two with laparoscopic partial nephrectomy. No postoperative therapy was applied. Patients were followed up for 15 to 64 months and there was no evidence of recurrence and metastasis. The MTSCC-K has special clinicopathological characteristics, low degree of malignancy and relative good prognosis. The diagnosis mainly depends on the histopathological examination and CT may help to differentiate with papillary renal cell carcinoma. Surgical treatment is recommended and additional therapies are not necessary.Virtual slides: The virtual slides for this article can be found here:
    Diagnostic Pathology 12/2013; 8(1):206. DOI:10.1186/1746-1596-8-206 · 2.60 Impact Factor
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    • "Markers of the proximal nephron such as CD10 and villin are generally absent. On the other hand, molecular studies indicate that MTSC lacks alterations associated with more common renal epithelial tumors [11, 12]. "
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    ABSTRACT: Mucinous tubular and spindle cell carcinoma (MTSC) is a rare and newly described type of renal cell carcinoma (RCC) with relatively indolent behavior. Although there are small series of this clinical entity in the literature, its histogenetic origin or line of differentiation remains unclear. A 67-year-old woman was hospitalized for flank pain; imaging studies revealed a 6.5-cm mass in the right kidney. She was referred for fine needle aspiration of the lesion, which showed an epithelial tumor with round to oval nuclei associated with strands of metachromatic stromal tissue. Cytopathologic diagnosis was consistent with RCC. Subsequent right heminephrectomy was performed and the surgical pathology specimen showed an MTSC of the kidney. The patient has done well postoperatively, with 24 months of benign follow-up. A precise differential diagnosis between MTSC and other renal carcinomas (e.g. papillary RCC with sarcomatoid transformation) is important for predicting patient prognosis. Even though MTSC is a rare cause of renal masses, it should be included in the differential diagnosis, especially because its imaging might be misleading, mimicking other benign renal diseases. Heminephrectomy is the preferred treatment in these subjects.
    Case Reports in Oncology 07/2012; 5(2):347-53. DOI:10.1159/000339802
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