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Mucinous tubular and spindle cell carcinoma of the kidney: Diagnosis by fine needle aspiration and review of the literature

机译：肾粘液性肾小管和梭形细胞癌：细针穿刺诊断及文献复习

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Renal mucinous tubular and spindle cell carcinoma (MTSCC) was recently described as a distinct subtype of renal cell carcinoma (RCC) in the 2004 World Health Organization classification of kidney tumors. MTSCC is a rare low grade malignancy with < 100 cases reported in the literature. To the best of our knowledge, there are 5 case reports with a total of 6 patients describing its diagnosis by fine needle aspiration (FNA). All of these cases were diagnosed as conventional RCC on FNA. Subsequent excisions proved them to be MTSCC. We herein report a case in a 67-year-old male. He presented with abdominal pain and was found to have a new colon adenocarcinoma with metastasis to the liver and lungs. The extent of disease made the patient ineligible for surgical excision, and he received chemotherapy. Work-up also revealed a kidney mass which was later biopsied by FNA and core biopsy. The tumor was composed of epithelial and spindled cell components embedded in a myxoid background. It was positive for CK7, AMCAR, vimentin, and epithelial membrane antigen. The tumor was diagnosed as MTSCC. One year later the kidney mass remained stable. However, the patient developed new metastasis to the liver from colonic primary. The kidney mass was not resected. Although rarely encountered in FNA cytology of the kidney, we believe the cytologic features of this tumor are distinctive and are different from conventional and other subtypes of RCC. Therefore, its accurate diagnosis on FNA is possible once pathologists are aware that MTSCC should be considered in the differential diagnosis of kidney tumors.
机译：肾粘液性小管和梭形细胞癌（MTSCC）最近在2004年世界卫生组织的肾脏肿瘤分类中被描述为肾细胞癌（RCC）的独特亚型。 MTSCC是一种罕见的低度恶性肿瘤，文献报道少于100例。据我们所知，有5例病例报告，共有6例患者描述了细针穿刺（FNA）诊断。所有这些病例均被诊断为FNA上的常规RCC。随后的切除证明它们是MTSCC。我们在此报告了一名67岁男性的病例。他表现出腹痛，被发现患有新的结肠腺癌，并转移至肝和肺。疾病的程度使患者不适合进行手术切除，他接受了化疗。检查还显示出肾脏肿块，随后由FNA和核心活检组织活检。该肿瘤由包埋在粘液样背景中的上皮细胞和纺锤状细胞组成。 CK7，AMCAR，波形蛋白和上皮膜抗原呈阳性。肿瘤被诊断为MTSCC。一年后，肾脏质量保持稳定。但是，患者从结肠原发灶转移到了肝脏。肾脏肿块未切除。尽管在肾脏的FNA细胞学中很少遇到，但我们认为该肿瘤的细胞学特征是独特的，并且与常规和其他RCC亚型不同。因此，一旦病理学家意识到在肾脏肿瘤的鉴别诊断中应考虑使用MTSCC，就可以对FNA进行准确的诊断。

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