Fine Needle Aspiration Biopsy of Renal Mucinous Tubular and Spindle Cell Carcinoma: Report of Two Cases

Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Diagnostic Cytopathology (Impact Factor: 1.12). 11/2009; 38(1):51-5. DOI: 10.1002/dc.21151
Source: PubMed


Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare renal tumor. Here we report two cases of MTSCC which were initially evaluated by fine needle aspiration biopsy (FNAB) and followed by surgical resection of the tumors. The cytomorphologic features of MTSCC were characterized by aggregates of relatively uniform, predominantly oval to spindle cells intermixed with abundant metachromatic myxoid matrix. Only rare epithelioid tumor cells with vacuolated cytoplasm were present. Immunohistochemically, the tumor cells were positive for CK7, CK19, CD10, vimentin, E-cadherin, alpha-methyl CoA racemase, and negative for CK903 and CK20. EMA and carbonic anhydrase IX immunoreactivity was seen in one of the two cases. Multiple chromosomal losses involving chromosomes 1, 2, 17 and likely chromosome 7 were revealed by fluorescence in situ hybridization (FISH). These cytomorphologic, immunophenotypic, and cytogenetic features were helpful for including this entity in the differential diagnosis of renal cell carcinomas.

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    • "This change is consistent with the previous literature and may provide references for the preoperative clinical diagnosis of MTSCC-K. In addition, it has been reported that fine needle aspiration biopsy may be diagnostic of MTSCC-K (12), which may aid to improve preoperative diagnosis rates. "
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    ABSTRACT: Mucinous tubular and spindle cell carcinoma of the kidney (MTSCC-K) is an unusual renal tumor. It is important to increase the recognition of MTSCC-K and improve the level of clinical diagnosis. The current study presents a case of MTSCC-K with clinical, imaging and pathological examination. A 60-year-old female presented to the First Hospital of Jilin University suffering from lumbodorsalgia on the right side for approximately one month, without gross hematuria and fever. Imaging examination by abdominal computed tomography scan revealed a ~6.5×5.0-cm solid mass in the inferior pole of the right kidney. The patient underwent laparoscopic radical resection of the right kidney. Pathological examination showed that the tumor was composed of small, elongated cords or tubules, in a tightly packed arrangement. Myxoid stroma was shown to be interspersed among the tubular cells, and appeared to exhibit slender tubular spindle cell-like structures. Tumor cells were smaller and cube-shaped or oval, with single small eosinophilic nucleoli and low-grade nuclei. Occasionally, necrosis and foam cell infiltration were observed. Myxoid stroma was stained by acidic mucus. Immunohistochemical markers, including CK7, CK19, EMA, Vimentin and P504S (AMACR) showed positive expression in tumoral cells, but the tumoral cells were CD10-negative. The MTSCC-K is a low-grade polymorphic renal epithelial neoplasm, which may be diagnosed by immunohistochemistry. The patients are likely to have an improved prognosis following surgery compared with patients with other renal cell carcinomas.
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    ABSTRACT: Thyroid-like follicular carcinoma of the kidney (TLFCK) is a recently described subtype of renal-cell carcinoma that is not currently included in the World Health Organization classification. Few sporadic case reports and one series have been reported with emphasis on histopathologic features. However, cytological features have not been described in the literature to date. A 34-year-old male presented with a renal mass. An intraoperative smear preparation of the tumor revealed a hypercellular smear with cells arranged in sheets without any follicular, papillary, or acinar arrangement. The most striking feature was the presence of acellular eosinophilic material associated with the neoplastic epithelial cells in the background of the smear. Individual tumor cells were oval, round, and plasmacytoid with mild nuclear pleomorphism, finely stippled nuclear chromatin, and inconspicuous nucleoli with moderate amount of eosinophilic cytoplasm and rare nuclear grooves. It was unclear at the time of the intraoperative assessment of the smear if the acellular eosinophilic material represented metachromatic matrix-like extracellular material, mucin, colloid, amyloid, or hyaline material. The differential diagnoses included a primary renal-cell carcinoma versus a metastatic tumor. Subsequent histopathologic examination was diagnostic of a rare, recently described primary neoplasm of the kidney called TLFCK. This work is a retrospective evaluation of the cytological features of TLFCK. It is important for cytopathologists to be aware of this entity and its cytological features to render a correct diagnosis for adequate management of these patients. Diagn. Cytopathol. 2012;. © 2012 Wiley Periodicals, Inc.
    No preview · Article · Mar 2014 · Diagnostic Cytopathology