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mucinous tubular and spindle cell carcinoma

Saturday 5 September 2009, by JA

Mucinous tubular and spindle cell carcinomas are low-grade renal epithelial neoplasms, which were first recognized as a specific entity in the World Health Organization 2004 classification.

Synopsis

- mean age of 53 years (17-82)
- female predominance (F:M=4:1)
- large eosinophilic regular spindle cells separated by a myxoid stroma with intercellular alcian-blue-positive clear droplets.
- In peripheral areas, elongated tubules and papillae covered by cubic cells

Immunochemistry

Immunohistochemistry favored a distal tubule origin (EMA(+), AE1/AE3(+), CK7(+), CK19(+), E-cadherin(+), AMACR(+), and CD10(-)).

Cytogenetics

In the literature, cytogenetic data indicate various chromosomal losses and gains, but no loss of 3p or trisomy 7 and/or trisomy 17.

In two cases, we demonstrate chromosomal loss involving chromosomes 1, 4, 6, 11, 8, 13, 14, 15, 18, and 22.

Differential diagnosis

Until this entity had been defined, pathologists used to classify these tumors as variants of solid papillary carcinomas with compressed and elongated papillae, metanephric adenomas, and sarcomatoid carcinomas.

References

- Mucinous tubular and spindle cell carcinoma of the kidney with sarcomatoid change. Dhillon J, Amin MB, Selbs E, Turi GK, Paner GP, Reuter VE. Am J Surg Pathol. 2009 Jan;33(1):44-9. PMID: #18941398#

- Papillary renal cell carcinoma with low-grade spindle cell foci: a mimic of mucinous tubular and spindle cell carcinoma. Argani P, Netto GJ, Parwani AV. Am J Surg Pathol. 2008 Sep;32(9):1353-9. PMID: #18670354#

- Mucinous tubular and spindle cell carcinoma with aggressive histomorphology—a sarcomatoid variant. Pillay N, Ramdial PK, Cooper K, Batuule D. Hum Pathol. 2008 Jun;39(6):966-9. PMID: #18400251#

- Mucinous tubular and spindle cell carcinoma of the kidney: cytopathologic findings. Owens CL, Argani P, Ali SZ. Diagn Cytopathol. 2007 Sep;35(9):593-6. PMID: #17703454#

- Expanding the histologic spectrum of mucinous tubular and spindle cell carcinoma of the kidney. Fine SW, Argani P, DeMarzo AM, Delahunt B, Sebo TJ, Reuter VE, Epstein JI. Am J Surg Pathol. 2006 Dec;30(12):1554-60. PMID: #17122511#

- Renal mucinous tubular and spindle carcinoma lacks the gains of chromosomes 7 and 17 and losses of chromosome Y that are prevalent in papillary renal cell carcinoma. Cossu-Rocca P, Eble JN, Delahunt B, Zhang S, Martignoni G, Brunelli M, Cheng L. Mod Pathol. 2006 Apr;19(4):488-93. PMID: #16554730#

- Mucinous tubular and spindle cell carcinoma of the kidney with neuroendocrine differentiation: report of two cases. Jung SJ, Yoon HK, Chung JI, Ayala AG, Ro JY. Am J Clin Pathol. 2006 Jan;125(1):99-104. PMID: #16482997#

- Immunohistochemical analysis of mucinous tubular and spindle cell carcinoma and papillary renal cell carcinoma of the kidney: significant immunophenotypic overlap warrants diagnostic caution. Paner GP, Srigley JR, Radhakrishnan A, Cohen C, Skinnider BF, Tickoo SK, Young AN, Amin MB. Am J Surg Pathol. 2006 Jan;30(1):13-9. PMID: #16330937#

- Genomic aberrations in mucinous tubular and spindle cell renal cell carcinomas. Brandal P, Lie AK, Bassarova A, Svindland A, Risberg B, Danielsen H, Heim S. Mod Pathol. 2006 Feb;19(2):186-94. PMID: #16258504#

- Mucinous tubular and spindle cell carcinoma: a report of 15 cases and a review of the literature. Ferlicot S, Allory Y, Compérat E, Mege-Lechevalier F, Dimet S, Sibony M, Couturier J, Vieillefond A. Virchows Arch. 2005 Dec;447(6):978-83. PMID: #16231179#

- Low-grade tubular-mucinous renal neoplasms: morphologic, immunohistochemical, and genetic features. Rakozy C, Schmahl GE, Bogner S, Störkel S. Mod Pathol. 2002 Nov;15(11):1162-71. PMID: #12429795#

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