Comparative study of CT and MRI appearances in mucinous tubular and spindle cell carcinoma and papillary renal cell carcinoma

2021 ◽  
pp. 20210548
Author(s):  
Dajun lu ◽  
Weibiao Yuan ◽  
Qingqiang Zhu ◽  
Jing Ye ◽  
Wenrong Zhu ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Spindle Cell ◽  
Papillary Renal Cell Carcinoma ◽  
Spindle Cell Carcinoma ◽  
Ct Imaging ◽  
Imaging Features ◽  
Unenhanced Ct ◽  
Ct And Mri

Objective: To explore the feasibility of CT and MRI in differentiating mucinous tubular and spindle cell carcinoma (MTSCC) and papillary renal cell carcinoma (PRCC). Methods: 23 patients with MTSCC and 38 patients with PRCC were studied retrospectively. CT and MRI were undertaken to investigate differences in tumour characteristics. Results: 23 patients with MTSCC and 38 patients with PRCC (included 15 cases Type 1,and 23 cases Type 2), tumours (mean diameter 3.7 ± 1.6 cm vs 4.6 ± 1.7 cm, p < 0.05), cystic components (5 vs 32, p < 0.01), calcifications (3 vs 11, p > 0.05), haemorrhage (1 vs 22, p < 0.01), tumour boundaries (1 vs 37, p < 0.01), and homogeneous enhancement (20 vs 11, p < 0.01). The density of MTSCC was lower than that of PRCC, normal renal cortex (p < 0.05), except for the medulla(p > 0.05). MTSCC and PRCC tumour enhancement were lower than that for normal cortex and medulla during all enhanced phases (p < 0.05). Enhancement was higher with PRCC than with MTSCC tumours during all phases (p < 0.05). On MRI, nine cases of MTSCC and 19 cases of PRCC, tumour showed homogeneous (9 vs 3, p < 0.01), heterogeneous (0 vs 16, p < 0.01), hyperintense on T1WI (0 vs 15, p < 0.01), slightly hyperintense on T2WI (9 vs 1, p < 0.01), hypointense on T2WI (0 vs 15, p < 0.05) , relatively high signal intensity was seen on DWI (9 vs 15, p > 0.05), respectively. Conclusion: CT imaging features of MTSCC include isodense or hypodense mass on unenhanced CT, with unclear boundaries; however, PRCC showed mild hyperdensity, easily have cystic components. The degree enhancement of MTSCC is lower than that for PRCC. On MR, MTSCC was slightly hyperintense on T2WI, whereas PRCC was hypointense. Advances in knowledge: 1.CT imaging features of MTSCC include isodense or hypodense mass on unenhanced CT, with unclear boundaries. 2. CT imaging features of PRCC include mild hyperdensity on unenhanced CT, easily have cystic components. 3. On enhanced CT, the degree enhancement of MTSCC is lower than that for PRCC. On MR, MTSCC was slightly hyperintense on T2WI whereas PRCC was heterogeneously hypointense on T2WI.

scholarly journals Combined Papillary Renal Cell Carcinoma with Neuroendocrine Differentiation and Mucinous Tubular and Spindle Cell Carcinoma

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Gang Wang ◽  
Ren Yuan ◽  
Tracy Tucker ◽  
Allan B. Gates ◽  
Christopher D. Bellamy ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Spindle Cell ◽  
Neuroendocrine Differentiation ◽  
Papillary Renal Cell Carcinoma ◽  
Spindle Cell Carcinoma ◽  
Unique Case ◽  
Primary Neoplasm

A unique case of combined papillary renal cell carcinoma (PRCC) and mucinous tubular and spindle cell carcinoma (MTSCC) presenting in a man aged 67 years is reported. The two separate components were distinct on morphological, immunohistochemical (IHC), and genetic grounds, while type 2 PRCC predominated. Three years after the initial diagnosis, the PRCC component metastasized to the lungs where it morphologically mimicked a pulmonary neuroendocrine tumor. Retrospectively focal neuroendocrine differentiation was demonstrated by IHC in the PRCC component of the primary neoplasm.

scholarly journals Difficulty in differential diagnosis for renal cancer with microscopic papillary architecture: overlapped pathological features among papillary renal cell carcinoma (RCC), mutinous tubular and spindle cell carcinoma, and unclassified RCC. Lessons from a Japanese multicenter study

2020 ◽  
Vol 50 (11) ◽  
pp. 1313-1320 ◽  
Author(s):  
Keiichi Ito ◽  
Shuji Mikami ◽  
Naoto Kuroda ◽  
Yoji Nagashima ◽  
Katsunori Tatsugami ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Multicenter Study ◽  
Renal Cell ◽  
Spindle Cell ◽  
Papillary Renal Cell Carcinoma ◽  
Spindle Cell Carcinoma ◽  
Cancer Center ◽  
Low Grade ◽  
Poor Risk

Abstract Objectives In our multicenter study evaluating metastatic papillary renal cell carcinoma (PRCC), 29% of tumors diagnosed as PRCC in collaborative institutes were finally diagnosed as other RCCs under central review. In those tumors, mucinous tubular and spindle cell carcinoma (MTSCC) was the leading histology, followed by unclassified RCC (ucRCC). We focused on those patients with MTSCC or ucRCC. Methods We reviewed the processes for the pathological diagnoses of nine tumors and reviewed their clinical features. Results All of the MTSCCs and ucRCCs were positive for AMACR, which is frequently positive in PRCC. Mucin was demonstrated in 80% of the MTSCCs, and its presence is important for their diagnoses. One MTSCC was diagnosed as a mucin-poor variant. The presence of spindle cells with low-grade nuclei was suggestive of MTSCC, but the diagnosis of high-grade MTSCC was difficult. Four tumors were diagnosed as ucRCC by histological and immunohistochemical findings. Three of the four tumors were suspicious of ucRCC in the initial review due to atypical findings as PRCC. Sunitinib and interferon-α were effective for one MTSCC patient who survived for &gt;5 years. Two MTSCC patients who were Memorial Sloan-Kettering Cancer Center poor risk had unfavorable prognoses. One patient with mucin-poor MTSCC had an indolent clinical course. Two of four ucRCC patients showed durable stable disease with targeted agents (TAs) and survived &gt;3 years. Conclusion Some MTSCC metastases progressed very slowly and poor-risk tumors progressed rapidly. Systemic therapies including TAs showed some efficacies. Some patients who have metastatic ucRCC with microscopic papillary architecture can benefit from TAs.

scholarly journals Mucin-Poor Mucinous Tubular and Spindle Cell Carcinoma of the Kidney Presented with Multiple Metastases Two Years after Nephrectomy: An Atypical Behaviour of a Rare, Indolent Tumour

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
I. Sokolakis ◽  
C. Kalogirou ◽  
L. Frey ◽  
M. Oelschläger ◽  
M. Krebs ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Spindle Cell ◽  
Left Kidney ◽  
Papillary Renal Cell Carcinoma ◽  
Spindle Cell Carcinoma ◽  
Rare Type ◽  
End Stage ◽  
Sarcomatoid Differentiation

Background. Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare type of renal cell carcinoma, whose clinical behaviour and metastatic potential have not been fully elucidated to date. There are only a few metastatic cases in the literature, which all either featured sarcomatoid differentiation or were synchronously metastasised at diagnosis. Case Presentation. We report a case of a 49-year-old male with end-stage kidney disease on dialysis, presenting with multiple osseous metastases of a mucin-poor variant of MTSCC of the kidney, without sarcomatoid differentiation, two years after bilateral nephrectomy for papillary renal cell carcinoma (RCC) at a curable stage. After retrospectively reexamining the initial nephrectomy specimens, the tumour of the right kidney was also diagnosed as a mucin-poor variant of MTSCC, while the tumour of the left kidney was confirmed as a papillary RCC. Conclusions. It is proposed that MTSCC can be associated with end-stage renal disease and that particularly the mucin-poor variant is easily confused with papillary renal cell carcinoma, as happened in this case. Although it is considered as a relatively indolent malign entity, it can metastasise even years after successful primary surgical treatment. This implies, besides accurate diagnosis, that MTSCC patients should be monitored closely in the follow-up period.

Papillary Renal Cell Carcinoma with Extensive Spindle Cell Foci: Mimicker of Mucinous Tubular and Spindle Cell Carcinoma

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S155-S155
Author(s):  
F Rajack ◽  
T J Naab
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Alcian Blue ◽  
Renal Cell ◽  
Spindle Cell ◽  
Correct Diagnosis ◽  
Papillary Renal Cell Carcinoma ◽  
Spindle Cell Carcinoma ◽  
High Grade ◽  
Cd10 Expression

Abstract Introduction/Objective Papillary Renal Cell Carcinoma (PRCC), the 2nd most common RCC, accounts for 10-15% of cases and is usually composed of tubules and papillae with foamy histiocytes in papillary cores. Mucinous tubular and spindle cell carcinoma (MTSC) is composed of tightly packed, elongated, curvilinear tubules with smooth luminal surfaces, separated by mucinous stroma. MTSC is associated with a more favorable prognosis than PRCC. PRCC and MTSC have significant histologic and histochemical overlap including elongated tubules and stromal Alcian blue positive mucin deposits. Methods/Case Report We report a case of a 75 year old female who underwent a robotic assisted partial nephrectomy for resection of a 5.7 x 5.2 x 5.0 cm left upper pole solid renal mass. Spindle cell change with elongated tubules reminiscent of MTSC was present in several blocks; however, the luminal surface was shaggy favoring PRCC. Patchy prominent extracellular Alcian blue positive mucin deposits were also present. PRCC and MTSC both express CK7, AMACR, and EMA. However, absent expression of E-cadherin and strong CD10 expression favored PRCC. Multiple foci of solid spindle cells in a whorled pattern with clear cell change, necrosis, and high grade nuclei bordering on sarcomatoid RCC were present in other blocks. Multiple papillations and psammoma bodies also supported PRCC. A spectrum of spindle cell change was present, ranging from elongated tubules reminiscent of MTSC to whorled foci with high grade nuclei approaching sarcomatoid RCC. Results (if a Case Study enter NA) NA Conclusion Submission of multiple sections and awareness of the protean morphologic features of PRCC are essential in making the correct diagnosis.

Sign in / Sign up

Export Citation Format

Share Document