<p>Several reports have documented renal cell carcinomas (RCC) with fibromyomatous stroma and with areas of hemangioblastoma (RCC FMS-HB). The hemangioblastoma component in RCC FMS-HB tumors was similar to the morphology of primary renal hemangioblastoma, suggesting that RCC FMS-HB and renal hemangioblastoma share common features. Seven study cases were collected, comprised of three RCC FMS-HB (two sporadic and one in a tuberous sclerosis patient) and four pure renal hemangioblastomas. A molecular analysis was successful in 6/7 cases. There were four males and three females, with an age range of 27 to 74&#xa0;years, and a mean age of 51&#xa0;years. The tumors measured from 2.6 to 5.5&#xa0;cm (median 3.5&#xa0;cm), and all were organ-confined, stage pT1. Median size for RCC FMS-HB was 2.8&#xa0;cm, and for renal hemangioblastoma, it was 3.5&#xa0;cm. The hemangioblastoma component in all RCC FMS-HBs and in all renal hemangioblastomas was positive for inhibin-α and S100 but was negative for CK7. In contrast, the clear-cell epithelial component in RCC FMS-HB was diffusely reactive for CK7 and was negative for inhibin-α and S100. Both components were reactive for CAIX, vimentin, and GPNMB. TSC/MTOR pathway alterations were found in 6/6 successfully evaluated cases, including 3/3 RCC FMS-HB and 3/3 renal hemangioblastomas, with mutations in <i>TSC1</i> (2/6), <i>TSC2</i> (2/6), and <i>MTOR</i> (2/6). The shared morphologic, immunohistochemical, and molecular features of RCC FMS-HB and renal hemangioblastoma indicate that they belong to a common biological spectrum, and that renal HB is a distinct entity from its <i>VHL</i>-altered central nervous system counterpart.</p>

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Renal hemangioblastoma and renal cell carcinoma with fibromyomatous stroma and hemangioblastoma-like areas belong to the spectrum of one entity

  • Kiril Trpkov,
  • Norel Salut,
  • Inmaculada Ribera-Cortada,
  • Elías Tasso Xipell,
  • Isabel Trias Puigsureda,
  • Asli Yilmaz,
  • Arjumand Riyaz Husain,
  • Erik Nohr,
  • Adrian Box,
  • Farshid Siadat,
  • Katherina Baranova,
  • Rola M. Saleeb,
  • Robert Stoehr,
  • Arndt Hartmann,
  • Abbas Agaimy

摘要

Several reports have documented renal cell carcinomas (RCC) with fibromyomatous stroma and with areas of hemangioblastoma (RCC FMS-HB). The hemangioblastoma component in RCC FMS-HB tumors was similar to the morphology of primary renal hemangioblastoma, suggesting that RCC FMS-HB and renal hemangioblastoma share common features. Seven study cases were collected, comprised of three RCC FMS-HB (two sporadic and one in a tuberous sclerosis patient) and four pure renal hemangioblastomas. A molecular analysis was successful in 6/7 cases. There were four males and three females, with an age range of 27 to 74 years, and a mean age of 51 years. The tumors measured from 2.6 to 5.5 cm (median 3.5 cm), and all were organ-confined, stage pT1. Median size for RCC FMS-HB was 2.8 cm, and for renal hemangioblastoma, it was 3.5 cm. The hemangioblastoma component in all RCC FMS-HBs and in all renal hemangioblastomas was positive for inhibin-α and S100 but was negative for CK7. In contrast, the clear-cell epithelial component in RCC FMS-HB was diffusely reactive for CK7 and was negative for inhibin-α and S100. Both components were reactive for CAIX, vimentin, and GPNMB. TSC/MTOR pathway alterations were found in 6/6 successfully evaluated cases, including 3/3 RCC FMS-HB and 3/3 renal hemangioblastomas, with mutations in TSC1 (2/6), TSC2 (2/6), and MTOR (2/6). The shared morphologic, immunohistochemical, and molecular features of RCC FMS-HB and renal hemangioblastoma indicate that they belong to a common biological spectrum, and that renal HB is a distinct entity from its VHL-altered central nervous system counterpart.