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- "Granular" Renal Neoplasms?
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stevenshen 离线
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This is a difficult case. Polygonal and round cells, with granular cytoplasm, sharp membrane, round to irregular nuclear, clear cell carcinoma or chromaphobe carcinoma should be considered. IHC stainings of vimentin, CD10(membrran, not cytoplasm expression) favor clear cell carcinoma(CK7-), while stainings of CK7, E-cadherin favor chromaphobe carcinoma(CD10 -, or cytoplasm staining). Finally, a combination of chromaphobe and oncytoma may suggest BDH syndrome. Thanks for the interesing case.
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| 以下是引用Lili0321在2009-1-9 21:33:00的发言： This is a difficult case. Polygonal and round cells, with granular cytoplasm, sharp membrane, round to irregular nuclear, clear cell carcinoma or chromaphobe carcinoma should be considered. IHC stainings of vimentin, CD10(membrran, not cytoplasm expression) favor clear cell carcinoma(CK7-), while stainings of CK7, E-cadherin favor chromaphobe carcinoma(CD10 -, or cytoplasm staining). Finally, a combination of chromaphobe and oncytoma may suggest BDH syndrome. Thanks for the interesing case. |
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- A: difficult to diagnosis - eosinophilic cell, may be perinuclear halo, slight irregular nuclear contour, and prominent cytoplamic membrane, and linear vascular pattern
- B: should be relatively easy - discohesive cells, round nuclei...
- C and D: almost impossible to tell the difference...will need to search for areas of fat and abnormal vessels for the diagnosis of angiomyolipoma and look for low grade clear cells with chicken-wire pattern vascular network for clear cell RCC.
A few comments about the "granular" renal neoplasm. Obviously this is only one small high power field of a neoplasm. I hope that most people would agree the most important for a correct diagnosis of a difficult case is to look at all areas of the tumor and adequate sampling.
