Cystic partially differentiated nephroblastoma in an adult: an immunohistochemical, lectin histochemical and ultrastructural study

Nagao, Toru; Sugano, Isamu; Ishida, Yuji; Tajima, Yoshifumi; Masai, Motoyuki; Nagakura, Kouichi; Matsuzaki, Osamu; Kondō, Yōichirō; Nagao, Kouichi

doi:10.1046/j.1365-2559.1999.00687.x

Cited by 19 publications

(14 citation statements)

References 27 publications

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“…A hobnail pattern is described in a wide range of tumors from different organs, including ovary 12 in which it is associated with both benign and malignant lesions. 7,15,18 In thyroid neoplasms, the loss of the cellular polarity/cohesiveness and hobnail features was first described in PTC by Tang et al 22 who found a correlation with retinoid receptor expression. Kakudo et al 11 suggested that they were useful parameters for identifying a distinctive group in common type PTC and in predicting patient's outcome in terms of tumor recurrence and cancer related death.…”

Section: Discussionmentioning

confidence: 98%

Papillary Thyroid Carcinoma With Prominent Hobnail Features: A New Aggressive Variant of Moderately Differentiated Papillary Carcinoma. A Clinicopathologic, Immunohistochemical, and Molecular Study of Eight Cases

Asioli¹,

Erickson²,

Sebo³

et al. 2010

American Journal of Surgical Pathology

171

142

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Papillary thyroid carcinomas (PTC) are the most common thyroid tumors that usually have a good prognosis. Recurrence, metastases, and cancer death may occur in a few patients and are more commonly associated with more aggressive tumors, such as tall cell, columnar cell, or diffuse sclerosing variants of the PTC. We present the clinicopathologic, immunohistochemical, and molecular features of a rare aggressive variant of the PTC showing prominent hobnail features. The patients included 6 females and 2 males. Ages ranged from 28 to 78 years (mean 57.6). Patients presented with a neck mass and cervical lymphadenopathy. Tumor size ranged from 1.0 cm to 4.0 cm (mean 2.5 cm). The tumors were usually multifocal with variably sized complex papillary structures lined by cells with increased nuclear/cytoplasmatic ratios and apically placed nuclei that produced a surface bulge (hobnail appearance). Thyroglobulin, TTF-1, HBME-1, and p53 were positive in all cases, and there was membrane staining for beta-catenin and E-cadherin. The proliferative index with Ki67 ranged from 2% to 20% with a mean of 10%. BRAF mutation was present in 4/7 (57.1%) cases. Distant metastases to liver, lung, bone, brain, muscle, and pancreas developed in 5 patients. The average follow-up time was 77.2 months. Four patients died of disease after a mean of 42.8 months. Two patients are alive with disease after 4 and 87 months, respectively. Two patients are alive without disease after 120 and 236 months. PTC with a prominent hobnail pattern is a moderately differentiated PTC variant with aggressive clinical behavior and significant mortality.

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Section: Discussionmentioning

confidence: 98%

Papillary Thyroid Carcinoma With Prominent Hobnail Features: A New Aggressive Variant of Moderately Differentiated Papillary Carcinoma. A Clinicopathologic, Immunohistochemical, and Molecular Study of Eight Cases

Asioli¹,

Erickson²,

Sebo³

et al. 2010

American Journal of Surgical Pathology

171

142

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“…Due to this criterion, the diagnosis of cystic partially differentiated nephroblastoma can be excluded in an adult patient with a renal neoplasm. In the literature we found an extremely rare case of this tumour reported in an adult [27,28]. The lesion is benign [1].…”

Section: Cystic Partially Differentiated Nephroblastomamentioning

confidence: 99%

Extensively Cystic Renal Neoplasms in Adults (Bosniak Classification II or III) – Possible “Common” Histological Diagnoses: Multilocular Cystic Renal Cell Carcinoma, Cystic Nephroma, and Mixed Epithelial and Stromal Tumor of the Kidney

et al. 2005

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Extensively cystic renal tumours classified as the Bosniak type II or III correspond histologically to the entities mentioned above (multilocular cystic renal cell carcinoma, cystic nephroma, mixed epithelial and stromal tumour of the kidney). These entities cannot be distinguished one from another on preoperative imaging studies. A preoperative biopsy and intra-operative frozen-section analysis do not lead to a correct diagnosis in many cases. Fortunately, the operative strategy is the same for all these tumours. In such cases, the nephron sparing surgery is indicated, whenever technically feasible, as almost all extensively cystic renal tumours have a good prognosis.

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“…3,4 This entity of tumours with similar morphologic findings had been previously described under various diagnoses, such as adult type mesoblastic nephroma, 5-8 cystic hamartoma of the renal pelvis, 9,10 cystic nephroma 11 or mature nephroblastic nephroma and cystic partially differentiated nephroblastoma. 12,13 Of the 100 reported cases of MEST in the literature, there are only 8 cases of men, including our case. [14][15][16] There is a possible hormonal pathogenetic mechanism involved in MEST -most female perimenopausal patients take longterm estrogen replacement therapy and the men with MEST have a history of hormone therapy.…”

Section: Discussionmentioning

confidence: 78%

Mixed epithelial and stromal tumor of the kidney (MEST) simulating

Sountoulides

Koptsis

Metaxa

et al. 2013

CUAJ

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We present a rare and interesting case of a mixed epithelial and stromal tumour (MEST) of the kidney. The case is unique as it involves a male patient with no history of hormonal therapy presenting with a filling defect in the renal collecting system and positive urine cytology. The patient was diagnosed with transitional cell carcinoma of the renal pelvis and subjected to nephroureterectomy, which revealed a solid tumour arising from the lower calyces and extending into the renal pelvis and upper ureter. Pathology revealed a MEST. The patient was disease-free at the 6-month follow-up. Case presentationA 50-year-old male was found with a mass in his left kidney on abdominal ultrasound during routine evaluation for lower urinary tract symptoms. On colour ultrasound, the mass was irregular, hypoechoic and involved the renal pelvis and lower calyces (Fig. 1). The patient's medical and family histories were insignificant and his physical examination did not reveal any abnormalities. The ultrasound findings were further evaluated with intravenous urography (IVU), which also revealed a smaller (about 9 cm) ectopic right kidney located in the true pelvis. The collecting system of the left kidney was mildly dilated with the presence of a filling defect in the lower calyces extending into the renal pelvis. The ectopic, smaller, right kidney was not dilated and the contrast medium was normally secreted to the bladder (Fig. 2).This finding raised a strong suspicion for transitional cell carcinoma (TCC) of the collecting system, although the patient was not a smoker. We ordered a computed tomography urography (CTU) for further clarification and staging and we planned a cystoscopy.Cystoscopy revealed a normal bladder urothelium. A ureteral catheter was advanced into the upper tract for barbotage and urine collection for cytology. Two voided specimens of urine were also collected for cytology. Cytology from the urine collected via the ureteral catheter was positive for high-grade transitional cell carcinoma (TCC).CTU confirmed the findings of IVU and revealed the presence of a filling defect caused by soft tissue mass arising from the anterior lower calyx and extending into the renal pelvis and the upper part of the ureter. The mass was causing dilatation of the renal pelvis. although there were no signs of enlarged lymph nodes or other pathology (Fig. 3, Fig. 4). Differential diagnosis included hemangioma, tuberculosis and TCC of the collecting system. However, in view of the positive urine cytology, the diagnosis of TCC of the collecting system was considered the most possible diagnosis. Nephroureterectomy was scheduled and nephrology consultation was requested because the patient had a possibly miss-functioning ectopic right kidney and was about to lose his other kidney.A renal scan with 99m Tc (DTPA) was done to evaluate renal function. Total glomerular filtration rate was 48 mL/ min (normal: >74 mL/min) and split renal function was 36.8 mL/min for the left kidney (77% of the total renal function) and 11 mL/min fo...

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Cystic partially differentiated nephroblastoma in an adult: an immunohistochemical, lectin histochemical and ultrastructural study

Abstract: CPDN does occur in adults, as experienced in Wilms' tumour, though its incidence is extremely low. This study suggests that CPDN may show maturation intermediate between cystic nephroma and Wilms' tumour, even in adult cases.

Cited by 19 publications

References 27 publications

Papillary Thyroid Carcinoma With Prominent Hobnail Features: A New Aggressive Variant of Moderately Differentiated Papillary Carcinoma. A Clinicopathologic, Immunohistochemical, and Molecular Study of Eight Cases

Papillary Thyroid Carcinoma With Prominent Hobnail Features: A New Aggressive Variant of Moderately Differentiated Papillary Carcinoma. A Clinicopathologic, Immunohistochemical, and Molecular Study of Eight Cases

Extensively Cystic Renal Neoplasms in Adults (Bosniak Classification II or III) – Possible “Common” Histological Diagnoses: Multilocular Cystic Renal Cell Carcinoma, Cystic Nephroma, and Mixed Epithelial and Stromal Tumor of the Kidney

Mixed epithelial and stromal tumor of the kidney (MEST) simulating

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