Prípad SD IAP č. 262. Klinické údaje: 76-ročný muž sledovaný pre tumor močového mechúra, na CT zachytený tumor pravej obličky priemeru 4 cm makro: sivočervený,

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Presentation transcript:

Prípad SD IAP č. 262

Klinické údaje: 76-ročný muž sledovaný pre tumor močového mechúra, na CT zachytený tumor pravej obličky priemeru 4 cm makro: sivočervený, dobre ohraničený, s drobnými dutinkami, subkapsulárny

RCC CK 7 VimentinEMA

Racemáza P504S

Imunohistochémia pozit.: EMA, M903, Vimentin (fokálne) P504S, AE 1/3 negat.: CD-10, RCC, SMA, Dezmín, HMB-45, CEA, CK7

Mucinous tubular and spindle cell carcinoma.

História Ordonez (1996), Loreta (1998), He (1998), Otani (2001) – neklasifikovaný Parwani (2001) – LG myxoid renal epithelial neoplasm Hes (2002), Razoky (2002) WHO 2004

LG polymorfný renálny tumor: mucinózny, tubulárny, spindle cell 17 – 82 rokov M / Ž – 1 / 4 v minulosti: neklasifikovaný alebo sarkomatoidný

Genetika WHO –losses: 1,4,6,8,13,14 –gains: 7,11,16,17 ???

Histogenéza distálny nefrón, Henleho kľučka proximálny nefrón, vzťah k papilárnemu Ca ?

Dif. dg. metanefrický adenóm onkocytóm LG Bellini konvenčný RCC papilárny RCC sarkomatoidný RCC juxtaglomerular cell tumor angiomyolipóm

Použitá literatúra WHO 2004 Expanding the Histologic Spectrum of Mucinous Tubular and Spindle Cell Carcinoma of the Kidney. Samson W. Fine, MD; Pedram Argani, MD; Angelo M. DeMarzo, MD, PhD; Brett Delahunt, MD; Thomas J. Sebo, MD; Victor E. Reuter, MD; Jonathan I. Epstein, MD, American Journal of Surgical Pathology. 30(12): , December Review of mucinous tubular and spindle-cell carcinoma of the kidney with a focus on clinical and pathobiological aspects, N. Kuroda, M. Toi1, M. Hiroi, T. Shuin and H. Enzan, Histopathol 20, (2005) Low-grade myxoid renal epithelial neoplasms with distal nephron differentiation, A. Parwani, Human Pathology, Volume 32, Issue 5, Pages Mucinous tubular and spindle cell carcinoma of kidney is probably a variant of papillary renal cell carcinoma with spindle cell features. Shen SS, Ro JY, Tamboli P, Truong LD, Zhai Q, Jung SJ, Tibbs RG, Ordonez NG, Ayala AG, Annals of diagnostic pathology 11 (2007)