Canadian Association of Pathologists - Case of the Month - September, 2007
Diagnosis:
Renal cell carcinoma, mucinous tubular and spindle cell type.
Explanation:
Sections show cuboidal cells with low grade nuclear features arranged in a tubular pattern and separated by pale mucinous stroma highlighted by alcian blue stain. On immunohistochemical staining, the tumor cells are positive for CK7, CAM5.2, 34Beta E12, EMA, and NSE. Staining for CD10, CD15, synaptophysin and chromogranin is negative. Based on morphology and immunohistochemical findings, a diagnosis of renal cell carcinoma, mucinous tubular and spindle cell subtype was made.
Notes:
Mucinous tubular and spindle cell carcinoma of kidney is more common in females and is associated with a favorable prognosis. These tumors generally lack markers of proximal nephron such as CD10.
References:
Fine SW, Argani P, DeMarzo AM, Delahunt B, Sebo TJ, Reuter VE, Epstein JI. Expanding the histologic spectrum of mucinous tubular and spindle cell carcinoma of the kidney. Am J Surg Pathol, 2006 Dec; 30(12): 1554-60.