Renal cell carcinoma. A histopathological analysis of the pseudocapsule of tumour and paritumoral parenchyma

Abstract Background MRI provides several distinct quantitative parameters that may better differentiate renal cell carcinoma (RCC) subtypes. The purpose of the study is to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC), chemical shift signal intensity index (SII), and contrast enhancement in differentiation between different subtypes of renal cell carcinoma. Results There were 63 RCC as regard surgical histopathological analysis: 43 clear cell (ccRCC), 12 papillary (pRCC), and 8 chromophobe (cbRCC). The mean ADC ratio for ccRCC (0.75 ± 0.13) was significantly higher than that of pRCC (0.46 ± 0.12, P < 0.001) and cbRCC (0.41 ± 0.15, P < 0.001). The mean ADC value for ccRCC (1.56 ± 0.27 × 10−3 mm2/s) was significantly higher than that of pRCC (0.96 ± 0.25 × 10−3 mm2/s, P < 0.001) and cbRCC (0.89 ± 0.29 × 10−3 mm2/s, P < 0.001). The mean SII of pRCC (1.49 ± 0.04) was significantly higher than that of ccRCC (0.93 ± 0.01, P < 0.001) and cbRCC (1.01 ± 0.16, P < 0.001). The ccRCC absolute corticomedullary enhancement (196.7 ± 81.6) was significantly greater than that of cbRCC (177.8 ± 77.7, P < 0.001) and pRCC (164.3 ± 84.6, P < 0.001). Conclusion Our study demonstrated that multiparametric MRI is able to afford some quantitative features such as ADC ratio, SII, and absolute corticomedullary enhancement which can be used to accurately distinguish different subtypes of renal cell carcinoma.

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Pulmonary metastasectomy in renal cell carcinoma: Predictive and prognostic elements from paired histopathological analysis of primary tumors and respective metastases

Journal of Onco-Nephrology ◽

10.1177/23993693211028593 ◽

2021 ◽

pp. 239936932110285

Author(s):

Melissa Bersanelli ◽

Sebastiano Buti ◽

Letizia Gnetti ◽

Elena Varotti ◽

Paolo Carbognani ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Prognostic Value ◽

Positive Impact ◽

Left Lung ◽

Pulmonary Metastasectomy ◽

Histopathological Analysis ◽

Primary Tumors ◽

Paired Samples

Objective: To identify histopathological and immunophenotypical features with potential predictive or prognostic value in patients undergoing pulmonary metastasectomy from renal cell carcinoma (RCC). Methods: We retrospectively collected all consecutive patients undergoing pulmonary metastasectomy from RCC after prior nephrectomy. Paired samples of primary tumors and corresponding pulmonary metastases were analyzed, revising histopathological features and testing C-MET, mTOR, and PD-L1 by immunohistochemistry. Results: A total of 25 patients were included. Median overall survival (mOS) from metastasectomy was 5.5 years (95% CI = 1.9–9.1). The laterality of metastases had a significant predictive value, with median relapse-free survival (mRFS) from metastasectomy not reached (NR) at mean follow-up (FU) of 60.8 months for left lung involvement, mRFS of 52.9 months (95% CI = 0–145.5) for the right lung and 6.4 months (95% CI = 1.7–11) for bilateral metastases ( p = 0.028). Primary RCC with positive expression of mTOR had higher mOS after metastasectomy than negative cases ( p < 0.001), NR at mean FU of 4.3 years versus mOS of 2 years (95% CI = 0.7–3.3), respectively. PD-L1 positivity on intra-tumor (TILs) and peri-tumor (RILs) infiltrating lymphocytes of metastases was related to higher OS, NR versus 2 years (95% CI = 1.2–2.7, p = 0.003), and NR versus 1.4 years (95% CI = 0.2–2.6, p = 0.012), respectively. The shorter was the surgical interval, the more probably the metastases had high c-MET expression (>70%) ( p = 0.007) and PD-L1 expression >10% on TILs ( p = 0.024). Conclusions: mTOR positivity on primary RCC could be a favorable prognostic factor to select patients for pulmonary metastasectomy. The positive impact of PD-L1 expression on immune cells is opposite to the well-known negative prognostic value of PD-L1 on tumor cells in RCC.

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Observational Histopathological Analysis of Renal Lesions in Nephrectomy Specimens

International Journal of Research and Review ◽

10.52403/ijrr.20210403 ◽

2021 ◽

Vol 8 (4) ◽

pp. 18-21

Author(s):

Anita Kumari ◽

Sarmistha Subhadarsini ◽

U S Pandey

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Care Center ◽

Chronic Pyelonephritis ◽

Histopathological Analysis ◽

Surgical Department ◽

Health Care Center ◽

Renal Lesions ◽

Malignant Lesions

Aim: This observational retrospective study was initiated to perform histopathological spectrum analysis of renal lesions from resected nephrectomy specimens. Materials and Methods: This was a retrospective observational study. Over a span of 4 years a total of 62 nephrectomy cases who underwent nephrectomy in a tertiary health care center and specimens were received from the surgical Department of the Hospital were analysed. Microscopic and gross features of the specimen were studied. Result: 12(19%) nephrectomy specimens out of 62 were malignant and 50 (81%) were benign. The mean age of patients from whom specimen were collected was 44.16 ± 29.8 years. 34 (54.9%) were Chronic Pyelonephritis cases, some associated with hydronephrosis and others with calculi. Out of 12 total malignant lesions 8 cases (12.9%) constituted as renal cell carcinoma. Among children commonest malignant tumour was Wilm’s tumour. Among the clinical presentation most common was flank pain in 17 (53.1%) cases followed by fever and burning micturition. Conclusion: In current study as compared to the benign tumours, malignant renal tumours far outnumbered. In paediatric age group most common malignancy was the Wilms tumour. Most common histomorphological diagnosis was Chronic Pyelonephritis and among the malignant lesions commonest were Renal Cell Carcinoma. Keywords: Nephrectomy, Histopathology, Chronic Pyelonephritis, Wilm’s tumour, Renal Cell Carcinoma.

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Histopathological analysis of T1 renal cell carcinoma: Does presentation matter?

Indian Journal of Urology ◽

10.4103/0970-1591.44257 ◽

2008 ◽

Vol 24 (4) ◽

pp. 504 ◽

Cited By ~ 2

Author(s):

Ganesh Gopalakrishnan ◽

Gaurav Gupta ◽

SamiranDas Adhikary ◽

Santosh Kumar ◽

NinanK Chacko ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Histopathological Analysis

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Composite Oncocytoma and Papillary Renal Cell Carcinoma of the Kidney Treated by Partial Nephrectomy: A Case Report

The Scientific World JOURNAL ◽

10.1100/tsw.2011.120 ◽

2011 ◽

Vol 11 ◽

pp. 1173-1177 ◽

Cited By ~ 6

Author(s):

Michael S. Floyd ◽

Saqib Javed ◽

Keloth E. Pradeep ◽

Alan R. De Bolla

Keyword(s):

Renal Cell Carcinoma ◽

Case Report ◽

Cell Carcinoma ◽

Partial Nephrectomy ◽

Renal Cell ◽

World Literature ◽

Left Kidney ◽

Papillary Renal Cell Carcinoma ◽

Histopathological Analysis ◽

Computerised Tomography

We present the case of a 73-year-old woman who presented with lethargy and a nonproductive cough. Computerised tomography of her abdomen revealed a 38-mm mass in the lower pole of her left kidney. She underwent a partial nephrectomy, with final histopathological analysis confirming the presence of a concomitant oncocytoma and papillary cell carcinoma. To our knowledge, this is the only case report in the world literature describing a papillary renal cell carcinoma within an oncocytoma treated by partial nephrectomy.

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Unusual site for metastatic renal cell carcinoma - a case report

Vojnosanitetski pregled ◽

10.2298/vsp180126057f ◽

2020 ◽

Vol 77 (2) ◽

pp. 233-236

Author(s):

Aleksandra Fejsa-Levakov ◽

Jelena Amidzic ◽

Jelena Ilic-Sabo ◽

Tanja Lakic ◽

Sasa Vojinov ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Case Report ◽

Cell Carcinoma ◽

Renal Cell ◽

Metastatic Tumor ◽

Multiple Organ ◽

Histopathological Analysis ◽

Unusual Site ◽

Regional Lymph Nodes ◽

Organ Systems

Introduction. The most common malignant tumor of the kidney is renal cell carcinoma (> 90%). The metastasis of the renal cell carcinoma in lingual base is very rare. Case report. Patient, 74 years old, renal cell carcinoma underwent radical nephrectomy with evacuation of regional lymph nodes and without any further therapy. After two years of disease-free period, patient appeared with the symptom of difficult swallowing. Ultrasound showed tumor spreading in number of organs. Histopathological analysis of tissue from lingual base confirmed metastatic tumor. Conclusion. After radical surgical treatment of the malignant disease, it is important to examine multiple organ systems. Appropriate approach to the diagnostics and evaluation the entire condition of the patient in this stage of the disease, especially lingual base can relieve patients discomfort and provide prolonged survival, even if the prognosis is unfavourable.

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