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Morphologic Spectrum of Renal Cell Carcinoma, Unclassified: An Analysis of 136 Cases

机译：肾细胞癌的形态学光谱，未分类：136例分析

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AimsRenal cell carcinoma, unclassified (RCCU) is a category that includes a morphologically and biologically heterogeneous group of tumors that are unable to be diagnosed as other well-defined entities. We aim to describe the morphologic findings of tumors within this category and to determine the most frequent morphologic features leading to classification difficulty.Methods and resultsOne hundred and thirty-six cases of RCCU were examined. Patients ranged in age from 23 to 87 years. Seventy-seven patients were men and 59 were women. International Society of Urological Pathology (ISUP) grade was most commonly 3 (n=66), followed by 2 (n=42) and 4 (n=28). Tumor size ranged from 0.6 cm to 24.9 cm. The AJCC pathologic T categories included pT1a (n=50), pT1b (n=14), pT2a (n=7), pT2b (n=4), pT3a (n=50), and pT4 (n=9). Forty-four cases included lymph node(s), of which 41% (n=18) had metastases. Tumors were assessed for a variety of histologic features and assigned to the following morphologic groups: predominantly oncocytoma/chromophobe RCC-like; clear cell RCC-like; papillary RCC-like; collecting duct-like; and pure sarcomatoid differentiation. The majority of the oncocytoma/chromophobe and clear cell RCC-like phenotypes were low stage (pT1 or pT2). The papillary RCC-like, collecting duct-like, and pure sarcomatoid phenotypes were mostly high stage (pT3 or pT4).ConclusionsRCCU is a term that encompasses tumors with a variety of morphologic features and a wide biologic spectrum. The most common source of diagnostic difficulty was tumors composed of predominantly eosinophilic cells.
机译：未分类的AimsRenal细胞癌（RCCU）是一类，包括形态学和生物学上均异质的一组肿瘤，这些肿瘤无法被诊断为其他定义明确的实体。我们旨在描述该类别肿瘤的形态学发现，并确定导致分类困难的最常见的形态学特征。方法和结果检查了136例RCCU。患者年龄在23至87岁之间。男77例，女59例。国际泌尿外科病理学会（ISUP）等级最常见的是3（n = 66），其次是2（n = 42）和4（n = 28）。肿瘤大小为0.6厘米至24.9厘米。 AJCC病理学T类包括pT1a（n = 50），pT1b（n = 14），pT2a（n = 7），pT2b（n = 4），pT3a（n = 50）和pT4（n = 9）。 44例包括淋巴结转移，其中41％（n = 18）有转移。对肿瘤的各种组织学特征进行了评估，并将其分为以下形态学组：主要为肿瘤细胞瘤/发色样RCC样；透明细胞样RCC；乳头状RCC样；收集管状和纯粹的肉瘤样分化。大部分的肿瘤细胞瘤/生色团和透明细胞RCC样表型是低阶段（pT1或pT2）。乳头状的RCC样，集合管样的和纯净的肉瘤样表型大多处于晚期（pT3或pT4）。结论RCCU是一个术语，涵盖了具有多种形态学特征和广泛生物学谱的肿瘤。诊断困难的最常见来源是主要由嗜酸性细胞组成的肿瘤。

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