Mucinous tubular and spindle cell carcinoma of the kidney (MTSCC-K) is

Mucinous tubular and spindle cell carcinoma of the kidney (MTSCC-K) is an unusual renal tumor. cords or tubules, in a tightly packed arrangement. Myxoid stroma was shown to be interspersed among the tubular cells, and appeared to exhibit slender tubular spindle cell-like structures. Tumor cells were smaller and cube-shaped or oval, with single small eosinophilic nucleoli and low-grade nuclei. Occasionally, necrosis and foam cell infiltration were observed. Myxoid stroma was stained by acidic mucus. Immunohistochemical markers, including CK7, CK19, EMA, Vimentin and P504S (AMACR) showed positive expression in tumoral cells, but the tumoral cells were CD10-negative. The MTSCC-K is a low-grade polymorphic renal epithelial neoplasm, which may be diagnosed by immunohistochemistry. The patients are likely to have an improved prognosis following surgery compared with patients with other renal cell carcinomas. and was known as a low-grade collecting duct carcinoma (2). As the number of MTSCC-K cases have increased continuously, this special type of kidney tumor has been described as a unique group of renal neoplasms composed of cytologically low-grade cells organized in tubules and spindled cords and set in an abundant extracellular mucinous matrix (3,4). In 2004, the World Health Organization recognized the tumor as a specific entity and officially named it MTSCC-K (5). MTSCC-K has a relatively good patient prognosis when compared with other malignant renal tumors (6). The present study analyzed the clinical results of a patient who presented to the First Hospital of Jilin University (Changchun, China) suffering from MTSCC-K, and performed a review of the relevant literature, to increase understanding of the tumor. Additionally the purpose of this study was to raise awareness of this tumor Metanicotine type for clinicians and pathologists in order to decrease the rate of misdiagnosis. Case report Clinical results A 60-year-old female presented to the First Hospital of Jilin University suffering from lumbodorsalgia on the right side for approximately one month, without gross hematuria and fever. Laboratory tests revealed no significant abnormalities in renal function, routine blood tests or urine routine. Imaging Metanicotine examination by abdominal computed tomography (CT) scan revealed a ~6.55.0-cm solid mass in the inferior pole of the right kidney. The tumor was well-circumscribed and protruding outside the renal contour, and no clear enhancement was identified in the arterial phase (Fig. 1). However, marginal uneven enhancement was observed in the venous phase (Fig. 2). No metastasis was identified to the retroperitoneal lymph node, abdominal organs or lungs. The patient provided written informed consent. Figure 1 Arterial phase computed tomography. The tumor showed no clear enhancement in this phase. Figure 2 Venous phase computed tomography. The tumor showed marginal uneven enhancement in this phase. Surgical procedures The patient was placed under general anesthesia and underwent laparoscopic radical resection of the right kidney (surgical excision of the right kidney, perirenal fat, a section of the ureter over and the right adrenal gland). Macroscopy Dissection of the specimen revealed that the tumor was well-circumscribed, solid and off-white, measuring ~7.06.56.5 cm. No areas of hemorrhage or necrosis were identified in the tumor. In addition, no invasion of the renal pelvis, renal C1qdc2 sinus or perirenal fat was identified. Microscopy The tumor was composed of small, elongated cords or tubules, in a tightly packed arrangement (Fig. 3). Myxoid stroma was shown to be interspersed among the tubular cells Metanicotine (Fig. 4), and appeared to exhibit slender tubular spindle cell-like structures (Fig. 5). Tumor cells were smaller and cubic-shaped or oval, with single small eosinophilic nucleoli and low-grade nuclei (Fig. 6). Occasionally, necrosis and foam cell infiltration were identified. The myxoid stroma was stained by acidic mucus (Fig. 7). Figure 3 Tumor was composed of small, elongated cords or tubules, in a tightly packed arrangement (hematoxylin and eosin; magnification, 10). Figure 4 Myxoid stroma was interspersed among the tubular cells (hematoxylin and eosin; magnification, 40). Figure 5 Slender tubular spindle cell-like structures (hematoxylin and eosin; magnification, 20). Figure 6 Tumor cells were smaller and cube-shaped or oval, with single small eosinophilic nucleoli and low-grade nuclei (hematoxylin and eosin; magnification, 40). Figure 7 Myxoid stromal staining by acidic mucus (alcian blue; magnification, 40). Immunohistochemistry CK7 (Fig. 8), CK19 (Fig. 9), EMA (Fig. 10), Vimentin and P504S (AMACR) showed positive expression in tumoral cells, but the tumoral cells were CD10-negative. Figure 8 CK7 showed positive expression in tumoral cells (magnification, 20). Figure 9 CK19 showed positive expression in tumoral cells (magnification, 10). Figure 10 EMA showed positive expression in tumoral cells (magnification, 10). Pathological results The tumor was well-circumscribed, measuring ~7.06.56.5 cm. Invasion of the renal pelvis, renal sinus or perirenal fat.

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