摘要
Abstract
Objective:Clear cell papillary renal cell tumor(CCPRCT)is a rare but significant type of renal tumor.It has similar morphological features to other renal cell tumors,which can easily lead to misdiagnosis.This study aims to investigate the clinical and pathological characteristics,diagnostic criteria,and differential diagnosis of CCPRCT to enhance the accuracy of its pathological diagnosis.
Methods:A total of 15 cases of CCPRCT were collected,and their clinical and radiological features were observed.The microscopic morphology and immunophenotype were analyzed,and relevant literature was reviewed.
Results:Among the 15 cases,10 were male and 5 were female,with age of(54±17)years.The tumors were located in the left kidney and five in the right.Histologically,all tumors were encapsulated by a thickened fibrous capsule and confined within the renal parenchyma.The tumor cells were arranged in papillary,tubular,cystic,acinar,and solid structures.The papillae ranged from small to medium-sized and were composed of a single layer of clear cells.All tumors were graded as World Health Organization/International Society of Urological Pathology(WHO/ISUP)grade 1 or 2.The cells exhibited reverse polarity,with nuclei positioned apically,similar to the arrangement of shark teeth.Immunohistochemical staining showed positive expression for cytokeratin 7,carbonic anhydrase 9(CA9),and high-molecular-weight cytokeratin(34βE12),negative expression for α-methylacyl-CoA racemase,CD117,and transcription factor E3.A typical U-shaped CA9 staining pattern was observed in CCPRCT,where the luminal edge was negative,but the base and lateral aspects were positive.No recurrences or metastases were observed during postoperative follow-up.
Conclusion:CCPRCT is an indolent renal cell tumor with a favorable prognosis.There is a potential for overdiagnosis clinically.Its morphological hallmark is the characteristic linear arrangement of nuclei oriented towards the luminal edge,and its distinctive immunophenotype with U-shaped positive CA9 can differentiate it from other renal cell tumors.However,more cases are still needed to further elucidate its prognosis.关键词
透明细胞乳头状肾细胞肿瘤/病理学特征/诊断/鉴别诊断Key words
clear cell papillary renal cell tumor/pathologic features/diagnosis/differential diagnosis
