Effusion cytology of renal cell carcinoma

Renshaw, Andrew A.; Comiter, Craig V.; Nappi, Carmela; Granter, Scott R.

doi:10.1002/(sici)1097-0142(19980625)84:3<148::aid-cncr5>3.0.co;2-k

Cited by 18 publications

(12 citation statements)

References 11 publications

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“…Effusions associated with renal cell carcinoma confer a poor prognosis. 6 We therefore believe that echo-free space (probably pleural effusion) in this patient may have been developed related to massive ascites, hypoalbuminemia, pleural metastases via Batson's venous plexus, or vascular leakage syndrome, which is characterized by an increase in vascular permeability accompanied by extravasation of fluids and proteins from the capillary vessels into the tissues. We have presented interesting echocardiographic images mimicking atrial dissection in the right atrium caused by an ileus due to metastatic renal cell carcinoma.…”

Section: Discussionmentioning

confidence: 97%

Atrial Dissection‐Like Appearance Caused by Ileus Due to Metastatic Renal Cell Carcinoma

et al. 2006

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Atrial dissection is an uncommon entity, defined as a gap from the mitral or tricuspid annular area to the interatrial septum or atrial wall, creating a new chamber with or without communication into the true left or right atrium. We present the interesting images of an atrial dissection-like appearance in the right atrium, which was actually caused by an ileus due to metastatic renal cell carcinoma in a 82-year-old man. The causes of true atrial dissection were also briefly discussed.

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Section: Discussionmentioning

confidence: 97%

Atrial Dissection‐Like Appearance Caused by Ileus Due to Metastatic Renal Cell Carcinoma

et al. 2006

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“…Malignant effusions, peritoneal or pleural, are rare in patients with RCC. [1] In large studies of effusion fluids, RCC has been the causative neoplasm in 1-2.2% of malignant pleural effusions. [3] However, benign effusions have also been reported in patients with advanced RCC, and hence, the presence of effusion does not correlate with the stage of primary tumor.…”

Section: Discussionmentioning

confidence: 99%

“…[1] However, even in such cases where papillae are seen in fluids, these may represent a conglomerate of proliferation spheres. Such proliferation spheres are characteristic of breast carcinoma, but can be seen in other adenocarcinoma as well.…”

Section: Discussionmentioning

confidence: 99%

“…[1] Due to the bland cytological appearance of cells from RCC, they can easily be confused with mesothelial cells. However, certain subtle cytological features, both architectural and cellular, favor a diagnosis of RCC.…”

Section: Introductionmentioning

confidence: 99%

“…[2] The presence of effusions in RCC portends an unfavorable prognosis, and hence an accurate diagnosis is essential. [1] An extensive review of literature yielded only an occasional report of RCC in peritoneal effusion fluids. [1] In these reports also, the subject of diagnosing RCC involvement in serous effusions is not dealt with in great detail.…”

Section: Introductionmentioning

confidence: 99%

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Cytomorphologic consideration in malignant ascites with renal cell carcinoma: A report of two cases

et al. 2010

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Effusions, especially peritoneal, are seen in less than 2% of patients with renal cell carcinoma (RCC). Since the tumor cells in RCC are bland and nondescript, the involvement of serous effusions is difficult to diagnose. An accurate recognition of malignant effusion and differentiation from reactive mesothelial cells is imperative. A 55-year-old male presented with gradually progressive ascites. Cytospin preparations from ascitic fluid showed reactive mesothelial cells admixed with few smooth-contoured clusters of cells with moderate cytoplasm, vesicular nuclei with prominent nucleolus. He had undergone nephrectomy for papillary RCC two years earlier. Another 36-year-old man underwent left nephrectomy for suspected RCC. Intra-operative ascitic fluid was sent for cytologic examination and showed numerous reactive mesothelial cells along with few clusters of cells with scant to moderate amount of cytoplasm, vesicular nucleus and a small nucleolus. Considering the histomorphology of the primary renal tumor in both cases, a cytologic diagnosis of malignant peritoneal effusion, morphologically compatible with RCC was rendered. RCC, due to its bland cytologic features, is easily overlooked in effusions. In a known patient, the cytopathologist must be extra vigilant to pick up the few cell clusters present in the fluid preparations and differentiate them from reactive mesothelial cells. A close inspection of the cytologic features and comparison with the histopathology of the primary tumor helps in making an accurate diagnosis.

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Immunohistochemistry for the detection of renal cell carcinoma in effusion cytology

Chute

Kong

Stelow

2011

Diagnostic Cytopathology

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Renal cell carcinoma (RCC) is known for its unpredictable behavior. RCC rarely involves serosal surfaces and, when present, can be difficult to distinguish from mesothelial cells in cytologic preparations. Immunohistochemical stains are frequently used with effusion cytology; however, RCCs express traditional glandular antigens less frequently than other adenocarcinomas. We investigated the utility of typical immunohistochemical stains for identifying effusion involvement by RCC, along with more specific RCC markers. The cytology databases from two academic institutions were searched for all effusions involved by RCC with retrievable cell-block material. A four-marker immunohistochemical panel we generally use for distinguishing adenocarcinoma from mesothelial proliferations was then applied (calretinin, WT1, MOC31, and B72.3). In addition, each case was stained for RCC antigen, CD10, and PAX2. Eleven cases of RCC involving serous effusions were identified: six conventional clear-cell RCCs, three papillary RCCs, and two RCCs, not otherwise specified. Neoplastic cells were positive for MOC-31 in 3 of 11 cases, RCC antigen in 5 of 11 cases, and CD10 in 10 of 11 cases. RCC cells were negative for B-72.3, WT1, and calretinin in all cases. Background mesothelial cells showed high-background cytoplasmic staining for PAX-2; all RCC tumor cells were negative or equivocal. A conventional panel used for the diagnosis of adenocarcinoma in fluids will fail to detect most cases of metastatic RCC, particularly clear-cell RCC. Additional antibodies, such as those to CD10 and RCC, may be helpful to identify these tumors. PAX2 shows high background in mesothelial cells, which makes interpretation of nuclear staining difficult.

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Effusion cytology of renal cell carcinoma

Cited by 18 publications

References 11 publications

Atrial Dissection‐Like Appearance Caused by Ileus Due to Metastatic Renal Cell Carcinoma

Atrial Dissection‐Like Appearance Caused by Ileus Due to Metastatic Renal Cell Carcinoma

Cytomorphologic consideration in malignant ascites with renal cell carcinoma: A report of two cases

Immunohistochemistry for the detection of renal cell carcinoma in effusion cytology

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