[771] Mucinous Tubular and Spindle Cell Carcinoma of the Kidney: A Clinicopathological, Immunohistochemical and Array Comparative Genomic Hybridization Study.

Shweta Chaudhary, Anupama Nayak, Tianyu Yang, Ion Chiosea, Qiulu Pan, Nora J Morgenstern, Theresa Y Chan, Y Albert Yeh. North Shore University Hospital, Manhasset, NY; Long Island Jewish Medical Center, New Hyde Park, NY; Montefiore Medical Center, Bronx, NY

Background: Mucinous tubular and spindle cell carcinoma (MTSCC), a rare variant of renal cell carcinoma, is characterized by its unique morphological, immunohistochemical and genetic findings. However, features which overlap with papillary renal cell carcinoma have been reported. We performed array comparative genomic hybridization (CGH) analysis on four cases of MTSCC.
Design: Four cases of MTSCC were retrieved from the pathology slide archives and array CGH was performed on all cases.
Results: Four cases included 2 men and 2 women with age range from 48 to 73 years. Two tumors occurred in the right and 2 in the left kidney. Partial nephrectomies were done and the tumor size varied from 2.1 to 4.0 cm. All the tumors had a pathologic stage of T1a. Macroscopically, MTSCCs displayed uniform light tan, yellow or gray tissues with minimal hemorrhage and necrosis. Microscopically, the neoplasms were composed of small elongated tubules embedded in a background of basophilic mucinous stroma. There were tumor cells arranged in curvilinear architecture separated by mucin. Closely parallel and collapsed tubular arrays with a spindle-cell appearance were present.

CaseCK7CD10AMACRVimentinHMWKCD117CK19/CAM5.2
1++++-ndnd/nd
2+-++ndndnd/+
3+-+---+/nd
4+focal-++focal--+focal/nd
nd: not done



CaseArray CGH
1-1,-6,-8,-13,-14,-15,-21,-22,12q del
2+7,+17
3-1,-4,-6,-8,-9,-13,-14,-15,-19,-21,-22, partial deletion 2q37,7p22,7p11-q11, 11p15,12q24,16p13,16q23
4-1,-4,-6,-8,-9,-13,-14,-15,-18,-22, partial deletion 19p12



Conclusions: There is overlap in the immunohistochemical findings of MTSCC and papillary renal cell carcinoma. Loss of chromosomes 1, 4, 6, 8, 9, 13, 14, 15, 21, 22 is the most consistent recurrent chromosomal aberrations in MTSCC. One of our cases which showed morphologic features of MTSCC showed gains of chromosomes 7 and 17, supporting classification as papillary renal cell carcinoma and in contrast to previous reports of papillary renal cell carcinoma with low grade spindle cell foci, it does show mucinous stroma. Therefore, our study illustrates that MTSCC can show morphologic and immunohistochemical features in common with papillary renal cell carcinoma, and genetics studies of such tumors can be helpful for correct classification.
Category: Genitourinary (including renal tumors)

Monday, February 28, 2011 9:30 AM

Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 106, Monday Morning

 

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