Case Of Mucinous Tubular And Spindle Cell Carcinoma Research Articles

Mucinous Tubular and Spindle Cell Carcinoma of the Kidney: A Study of Clinical, Imaging Features and Treatment Outcomes.

PurposeTo describe the clinical, imaging, pathological features and oncologic outcomes of mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney.Patients and MethodsTwenty-two cases of MTSCC were pathologically identified between January 2004 and April 2021 at our institution. The clinical and imaging findings, pathological features, treatment methods and outcomes of the patients were reviewed.ResultsThese cases included 17 women and 5 men, with a median age at diagnosis of 52.5 years. On contrast-enhanced CT, MTSCC was less enhanced than the adjacent renal parenchyma. Tumor attenuation values were 33.3 ± 6.8HU, 44.0 ± 9.1HU, 54.4 ± 13.9HU and 67.1 ± 11.8HU in the non-contrast, corticomedullary, nephrographic and excretory phases of CT, respectively. Contrast-enhanced ultrasonography and MRI also showed hypovascular features of the masses. On MRI, the tumors were isointense on T1-weighted images and slightly hypo- or hyperintense on T2-weighted images. Diffusion-weighted imaging revealed a low apparent diffusion coefficient of the tumor. The patients were managed with laparoscopic partial nephrectomy (n=5), radical nephrectomy (n=16), or robotic-assisted laparoscopic partial nephrectomy (n=1). The median follow-up time was 59.5 months. All the patients were free of local recurrence or distant metastasis.ConclusionsMTSCC is generally indolent and has favorable outcomes. The imaging features of MTSCC are generally hypovascular, which is significantly different from clear cell renal cell carcinoma. However, it is still difficult to distinguish MTSCC from other hypovascular renal tumors preoperatively because their imaging features overlap. Further studies are essential to fully characterize the features of this rare RCC variant.

Mucinous tubular and spindle cell carcinoma of the kidney with prominent papillary component, a non-classic morphologic variant. A histologic, immunohistochemical, electron microscopic and fluorescence in situ hybridization study

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. Immunohistochemistry 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 ultrastructural 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.

CT of a renal mucinous tubular and spindle cell carcinoma.

Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare renal epithelial neoplasm which has only been recently described. It is characterized pathologically by tightly packed, elongated tubules with transition into spindle cell areas and mucinous stroma. Previous literature has laid particular emphasis on its pathology manifestations, while radiological features have not been well studied. We herein report the CT features of a case of MTSCC. The CT findings of MTSCC present certain characteristics in the case. The radiological morphology of this low-grade tumor helps its differentiation from sarcomatoid renal carcinoma.

436 IDENTIFICATION OF UNIQUE GENOMIC PROFILES OF COLLECTING DUCT CARCINOMA

You have accessJournal of UrologyKidney Cancer: Basic Research III1 Apr 2012436 IDENTIFICATION OF UNIQUE GENOMIC PROFILES OF COLLECTING DUCT CARCINOMA Toru Inoue, Keiko Matsuura, Chisato Nakada, Takeo Nomura, Fuminori Sato, Yoji Nagashima, Chikara Ohyama, Tomonori Habuchi, Yasuhiko Tomita, Satoru Takahashi, Osamu Ogawa, Norio Nonomura, Akio Matsubara, Masayuki Nakagawa, Masatsugu Moriyama, and Hiromitsu Mimata Toru InoueToru Inoue Yufu, Japan More articles by this author , Keiko MatsuuraKeiko Matsuura Yufu, Japan More articles by this author , Chisato NakadaChisato Nakada Yufu, Japan More articles by this author , Takeo NomuraTakeo Nomura Yufu, Japan More articles by this author , Fuminori SatoFuminori Sato Yufu, Japan More articles by this author , Yoji NagashimaYoji Nagashima Yokohama, Japan More articles by this author , Chikara OhyamaChikara Ohyama Hirosaki, Japan More articles by this author , Tomonori HabuchiTomonori Habuchi Akita, Japan More articles by this author , Yasuhiko TomitaYasuhiko Tomita Yamagata, Japan More articles by this author , Satoru TakahashiSatoru Takahashi Tokyo, Japan More articles by this author , Osamu OgawaOsamu Ogawa Kyoto, Japan More articles by this author , Norio NonomuraNorio Nonomura Osaka, Japan More articles by this author , Akio MatsubaraAkio Matsubara Hiroshima, Japan More articles by this author , Masayuki NakagawaMasayuki Nakagawa Kagoshima, Japan More articles by this author , Masatsugu MoriyamaMasatsugu Moriyama Yufu, Japan More articles by this author , and Hiromitsu MimataHiromitsu Mimata Yufu, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.503AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Collecting duct carcinoma (CDC) is a relatively rare subtype of renal cell tumors. It is sometimes difficult for pathologists to distinguish CDC from high grade papillary renal cell carcinoma (PRCC), mucinous tubular and spindle cell carcinoma (MTSCC) and invasive urothelial carcinoma (UC) of renal pelvis. Aim of this study is to analyze the genomic profiles by array comparative genomic hybridization (aCGH) and clarify whether aCGH is useful for the differential diagnosis of CDC. METHODS 9 cases of CDC, 4 cases of MTSCC, 3 cases of high grade PRCC and 14 cases of invasive UC were analyzed. Carcinoma cells were collected from paraffin-embedded tissue sections by laser-captured microdissection and subjected to aCGH using Whole Human Genome 4x44K Oligo Micro Array (Agilent). RESULTS Array CGH analysis revealed that, in more than 50% of cases of CDC, gene copy number gains at 17q and 8q and losses at 1p, 3p, 4pq, 6q, 9pq, 11q, 13q, 14q, 18q and 22q were detected (Figure). The pattern of genomic profiles of CDC was evidently distinct from those of UC and papillary RCC. Unsupervised hierarchical cluster analysis of the aCGH data of 30 cases revealed that they were divided into 3 groups (Clusters A, B and C). Cluster A contained 13 cases including 8 cases of CDC, 3 cases of MTSCC and 2 cases of UC, indicating that most of CDCs and MTSCCs were categorized in the cluster A. Cluster B contained 3 cases of papillary RCC, one case of MTSCC, one case of UC and one case of CDC. On the other hand, Cluster C contained only 11 cases of UC. Interestingly, 8 of 9 cases of CDC was categorized in Cluster A and 3 of the 4 cases of MTSCC were also categorized in Cluster A, suggesting that genomic profiles of CDC may be distinct from those of UC and papillary RCC, but genomic profiles of MTSCC cannot be discriminated from those of CDC. CONCLUSIONS The patterns of CNAs of CDC are unique and different from those of the other histologic subtypes except for MTSCC. On the basis of the pattern of CNAs, MTSCC is suggested to be classified as a CDC-related subtype. Genomic profiling using aCGH is useful for the differential diagnosis of CDC, high grade papillary RCC and invasive UC. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e179 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Toru Inoue Yufu, Japan More articles by this author Keiko Matsuura Yufu, Japan More articles by this author Chisato Nakada Yufu, Japan More articles by this author Takeo Nomura Yufu, Japan More articles by this author Fuminori Sato Yufu, Japan More articles by this author Yoji Nagashima Yokohama, Japan More articles by this author Chikara Ohyama Hirosaki, Japan More articles by this author Tomonori Habuchi Akita, Japan More articles by this author Yasuhiko Tomita Yamagata, Japan More articles by this author Satoru Takahashi Tokyo, Japan More articles by this author Osamu Ogawa Kyoto, Japan More articles by this author Norio Nonomura Osaka, Japan More articles by this author Akio Matsubara Hiroshima, Japan More articles by this author Masayuki Nakagawa Kagoshima, Japan More articles by this author Masatsugu Moriyama Yufu, Japan More articles by this author Hiromitsu Mimata Yufu, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Mucinous tubular and spindle cell carcinoma of kidney: a clinicopathological study

To investigate the clinicopathological features, histogenesis and prognosis of mucinous tubular and spindle cell carcinoma (MTSCC). Five MTSCCs were studied with histochemical, immunohistochemical staining, electron microscopy, and review of the related literatures. Four cases of MTSCC were females and one was male. Three patients presented with flank discomfort and two were incidentally found with health examination. In gross examination, the tumors were circumscribed. The cut surface was solid, gray-white, yellow or red. Necrosis was present in one case of high-grade MTSCC. Microscopically, low-grade MTSCC was mainly consisted of tubular, spindle cell and mucinous stroma with relatively bland morphology, and mitoses were rare. While in the high-grade area of one case, the cells were spindle or polymorphic with severe atypia and high mitotic activity, without mucinous stroma and tubular structure. Mucin was positive for Alcian blue. The neoplastic cells were positive for vimentin (5/5), CKpan (5/5), CK7 (5/5), CK19 (5/5), 34betaE12 (1/5), EMA (5/5), E-cadherin (3/5), CD10 (1/5), P504S (5/5), and CAM5.2 (5/5). The Ki-67 index was low (< or = 5%) in the low-grade component, while it was high (15%) in the high-grade component. Ultrastructural study showed short microvilli along glandular lumens. The nuclear membrane was focally invaginated. Four cases were followed up for 3 to 52 months, and recurrence and metastasis were not found. MTSCC occurs predominantly in females and it is a rare kidney neoplasm. Most of MTSCCs are low-grade and the prognosis is relatively good. However, the patients of high-grade MTSCC should be closely followed up.

Clinical and pathologic features of renal mucinous tubular and spindle cell carcinoma

To investigate the clinical and pathological features of the mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney. Seven cases of MTSCC were analyzed by gross examination and light microscopy. Immunostaining was performed to detect the expression of CD10, CK7, CK18, CK19, Villin, EMA, P504S and vimentin. The literature on this tumor was reviewed to discuss the histological features of MTSCC and its clinical behavior. Three of 7 cases were male and the other 4 were female. The mean age of the patients was 48.2 years old, with a range from 39 to 61 years. All the patients presented no symptom and their tumors were found by health examination. Tumors averaged 5.5 cm in greatest dimension (range from 4.0 cm to 9.0 cm). The tumors were well-circumscribed without capsules, and the cut surfaces were solid and soft with white-tan color. By light microscopy, tumors were composed of tightly packed, small, elongated tubules with transitions to spindle cell components. Five cases had mucinous stroma. Clear cell clusters, focal sarcomatoid differentiation, papillations and foamy macrophages were seen in several cases. Immunohistochemically, all 7 cases showed positive for CK7, five of 5 cases positive for EMA, CK18 and P504S, four of 5 cases positive for CK19, but heterogeneous for CD10, villin and vimentin expression. No evidence of local recurrence or distant metastases was identified in the 5 patients with follow-up information. The mucinous tubular and spindle cell carcinoma is a low-grade and polymorphic neoplasm. The morphology of these tumors may not be uniform with a wide histological spectrum. The tumors can be tubular predominant or spindle cells predominant with scant to abundant mucinous stroma, which coupled with the presence of other unusual features such as clear cells, papillations, foamy macrophages, necrosis and sarcomatoid differentiation. Immunohistochemically, MTSCC can express the markers from the proximal convoluted tubules to collecting tubules.

Fine needle aspiration biopsy of renal mucinous tubular and spindle cell carcinoma: Report of two cases

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.

Mucinous tubular and spindle cell carcinoma with Fuhrman nuclear grade 3: a histological, immunohistochemical, ultrastructural and FISH study.

Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney generally shows low nuclear grade. MTSCC with high nuclear grade is relatively rare. In this article, we report two cases of MTSCC with Fuhrman grade 3. One case occurred in a 57-year-old Japanese female and the second case in a 49-year-old Caucasian female. Histologically, the tumors were composed of neoplastic cells with cuboidal or columnar and spindle morphology, and Fuhrman nuclear grade 3. The myxoid stroma was also observed. This stroma was positive for Alcian blue stain. Immunohistochemically, neoplastic cells of both cases were positive for AMACR, but negative for CD10 and RCC Ma. Ultrastructurally, tumorous cells of one case contained numerous mitochondria. In FISH analysis, many neoplastic cells of both cases demonstrated monosomy of chromosomes 15 and 22 and disomy of chromosomes 7 and 17. One of the two patients died of respiratory failure due to pleuritis carcinomatosa 48 months postoperatively. Finally, the pathologist should recognize that high grade MTSCC exists despite its rare frequency. FISH analysis may be helpful in establishing the diagnosis of this entity. Furthermore, we present the first report of a patient with MTSCC dying of distant metastasis.