Mucinous tubular and spindle cell carcinoma and solid variant papillary renal cell carcinoma: a clinicopathologic comparative analysis of four cases with similar molecular genetics datum.

Yanling Zhang,Qiong Wu,Qiong Zhang,Xiang Yong,Shiwu Wu,Donghong Yu,Xiaoli Wang

doi:10.1186/s13000-014-0194-8

Abstract

Mucinous tubular and spindle cell carcinoma (MTSC) was first recognized as a specific entity in the World Health Organization 2004 classification. The “classic” tumor presentation includes an extracellular blue-gray mucinous/myxoid matrix accompanying the typical tubular and spindle cell epithelial components. Tubules are lined by cuboidal to columnar cells with bland nuclei, central small to medium sized nucleoli, and few to no mitoses. By expanding the histologic spectrum, a number of studies highlighted the distinction between MTSC and solid variant of papillary renal cell carcinoma (sPRCC), although controversy still exists. Here, we evaluated two cases of MTSC and compared two cases of sPRCC by light microscopy, special staining, immunohistochemical staining and fluorescence in situ hybridization (FISH). We found that morphologic and immunophenotyping features showed more overlap between MTSC and sPRCC. In addition, gains of chromosomes 7 and 17 and loss of Y, which are characteristic of PRCC, were observed in two cases of sPRCC and one case of MTSC, suggesting that MTSC is similar to sPRCC or may be a subtype of PRCC.Virtual Slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_194

Highlights

Mucinous tubular and spindle cell carcinoma (MTSC) was first recognized as a specific entity in the World Health Organization 2004 classification [1]
Solid variant of papillary renal cell carcinoma is a rare variant of papillary renal cell carcinoma that was first recognized by Renshaw et al [2]
Our results proved that MTSC and Solid variant of papillary renal cell carcinoma (sPRCC) have overlapping morphological and immunohistochemical markers, including macroscopically, both of MTSC and sPRCC are well circumscribed, the cut surfaces are greyish-white in color

Summary

Introduction

Mucinous tubular and spindle cell carcinoma (MTSC) was first recognized as a specific entity in the World Health Organization 2004 classification [1]. The “classic” tumor presentation includes an extracellular blue-gray mucinous/myxoid matrix accompanying the typical tubular and spindle cell epithelial components. Whole tumor cells are arranged in solid sheets or tubular structures and foci are. Morphologic overlap between MTSC and sPRCC has been reported, and a number of studies highlighted the distinction between MTSC and sPRCC, such as Paner et al [8], who considered that MTSC and sPRCC with sarcomatous change can be distinguished by the spindle cell component with atypia. Argani et al [9] reported five cases of sPRCC accompanying low-grade spindle cell tumors, a morphology that is difficult to distinguish from MTSC,

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Discussion

Conclusion