Uropathology
Walid S. H. Elsayed; Ola Harb; Mohamed A Alabiad; Rema H. Faraj Saad; Amal Anbaig; Mohamed Alorinin; Rehab Hemeda; Mohamed Negm; Loay M Gertallah; Walled A Abdelhady; Ramadan M Ali
Abstract
Background & Objective: Cells of renal cell carcinoma (RCC) are resistant to the most currently used chemotherapeutic agents and targeted therapies; hence, we evaluated the expression of NEK2, JMJD4, and REST in tissues of clear cell renal cell carcinoma (ccRCC) and benign nearby tissues of kidney ...
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Background & Objective: Cells of renal cell carcinoma (RCC) are resistant to the most currently used chemotherapeutic agents and targeted therapies; hence, we evaluated the expression of NEK2, JMJD4, and REST in tissues of clear cell renal cell carcinoma (ccRCC) and benign nearby tissues of kidney with the aim of detecting associations between their expression and clinicopathological features, prognostic data, tumor recurrence, and survival rates.Methods: We collected 200 samples from tumor and adjacent non-neoplastic tissues of 100 ccRCC patients. All samples were evaluated for the expression of NEK2, JMJD4, and REST, and the patients were followed up for about 5 years. Tumor recurrence and survival data were collected and analyzed.Results: NEK2 and JMJD4 expression was increased in ccRCC tissues (P=0.002 and 0.006), while REST was downregulated (P<0.001). The elevated expression of NEK2 was positively related with big tumor size (P=0.015), higher grades (P=0.002), higher stages (P=0.013), distant spread (P=0.004), tumor recurrence, shorter progression-free survival (PFS) rate, and overall survival (OS) rate (P<0.001). Likewise, the high expression of JMJD4 was positively related with big tumor size (P=0.047), higher grades (P=0.003), higher stages (P=0.043), distant spread (P=0.001), tumor recurrence, shorter PFS rate, and OS rate (P<0.001). Conversely, Low expression of REST was positively related to big tumor size, higher grades, higher stages, distant spread, tumor recurrence, and shorter PFS and OS rates (P<0.001).Conclusion: We demonstrated that overexpression of NEK2 and JMJD4 and downregulation of REST were found in malignant than benign renal tissues and were related to unfavorable pathological findings, poor clinical parameters, and poor patient outcomes.
Nephropathology
Hedieh Moradi Tabriz; Arezoo Eftekhar-Javadi; Atiieh Zandnejadi
Abstract
Thyroid gland metastatic tumors are rare in clinical practice. Clear cell RCC is one of common metastatic tumors to thyroid. We here reported a case of incidentally found clear cell renal carcinoma metastasis to the thyroid gland 3 years after nephrectomy, in the thyroidectomy procedure performed for ...
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Thyroid gland metastatic tumors are rare in clinical practice. Clear cell RCC is one of common metastatic tumors to thyroid. We here reported a case of incidentally found clear cell renal carcinoma metastasis to the thyroid gland 3 years after nephrectomy, in the thyroidectomy procedure performed for the patient due to the thyroid enlargement caused by multinodular goiter. A 65-year-old Iranian man with a history of multinodular goiter referred to our surgery clinic for thyroidectomy because of compressive effects on the trachea. Patient had a history of nephrectomy due to clear cell RCC 3 years ago. After thyroidectomy, gross and histological examination of thyroid revealed clear cell renal carcinoma metastasis to the thyroid gland in the setting of a multinodular goiter. The diagnosis was confirmed by immunohistochemistry staining. Patients with multinodular goiter are more prone to present with metastasis to thyroid gland if they have a history of malignancy, especially renal cell carcinoma.
Uropathology
Sushma Bharti; Gautam Ram Choudhary; Jyotsna Naresh Bharti; Garg Pawan Kumar; Arsha BS; Poonam Abhay Elhence
Abstract
Clear cellrenal cell carcinoma (RCC) is the most common malignant renal tumor in adults, while chromophobe RCC (CRCC) is the third most common. Any subtypes of RCC can undergo sarcomatoid differentiation, but heterologous differentiation in sarcomatoid area is very rare in RCC. Here a61-year male is ...
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Clear cellrenal cell carcinoma (RCC) is the most common malignant renal tumor in adults, while chromophobe RCC (CRCC) is the third most common. Any subtypes of RCC can undergo sarcomatoid differentiation, but heterologous differentiation in sarcomatoid area is very rare in RCC. Here a61-year male is presented with hematuria and palpable mass. Clinicoradiologically, RCC was considered and left radical nephrectomy was performed. A well-circumscribed renal mass located in the upper pole of the left kidney with variegation and extensive areas of bony hard calcification noted, was reported as CRCC with sarcomatoid differentiation containing heterologous component. CRCC subtype has good prognosis but show dismal prognosis when associated with sarcomatous differentiation.We found11 cases of sarcomatoid CRCC containing heterologous elements reported in indexed English literature. CRCC must be differentiated from Conventional RCC and Oncocytoma.The extensive sampling of the tumor is needed. We report a very rare case of CRCC with sarcomatoid differentiation containing heterologous elements.
Bone & Soft tissue Pathology
Ramesh Omranipour; Habibollah Mahmoudzadeh; Freshteh Ensani; Samira Yadegari; Seyed Rohollah Miri
Abstract
Renal cell carcinoma (RCC) metastasis to duodenum is very rare and only a few case reports are available in the literature. We here reported a patient with solitary duodenal metastasis presented with melena six years after right nephrectomy. The patient underwent upper gastrointestinal endoscopy showing ...
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Renal cell carcinoma (RCC) metastasis to duodenum is very rare and only a few case reports are available in the literature. We here reported a patient with solitary duodenal metastasis presented with melena six years after right nephrectomy. The patient underwent upper gastrointestinal endoscopy showing ulcerative mass at the second portion of duodenum and biopsy of this mass was consistent with metastatic RCC. Metastasis work up did not find any other site of malignancy, thus Whipple’s operation (Pancreaticoduodenectomy) was performed. In conclusion metastasis from RCC should be considered in mind in patients with history of nephrectomy presenting with gastrointestinal symptoms and a complete evaluation, especially endoscopic examination followed by biopsy, is suggested.
Mahmoud Reza Kalantari; Tayyebeh Nazeran; Fatemeh Varshoee Tabrizi
Volume 7, Issue 3 , July 2012, , Pages 157-164
Abstract
Background and Aims: P504S (AMACR) is a mitochondrial enzyme expressed in renal cell carcinoma. Some of immunohistochemical markers in renal cell tumors are independent prognostic factor and show relation with histologic grading. AMACR expression increases with higher histological grading in different ...
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Background and Aims: P504S (AMACR) is a mitochondrial enzyme expressed in renal cell carcinoma. Some of immunohistochemical markers in renal cell tumors are independent prognostic factor and show relation with histologic grading. AMACR expression increases with higher histological grading in different tumors; however, in RCC it is not obvious. In this study, we tried to investigate if any relation existed between nuclear grading in renal cell carcinoma and P504S.
Materials & Methods: Fort five cases of formalin fixed paraffin embedded tissue of renal cell carcinoma with different nuclear grades were selected and immunostained using primary antibody to P504s and quantified with H-Score, multiplicative (Mqs) and Additive quick score (Aqs).
Results: P504S was positive in 37 out of 45 (82%) cases. (Mean ± SD) of H-Score: grade I =182±44. II=218±161, III=215±55, IV=190. Mean ± SD of Add quick score: grade I= 6.6± 1.8, II= 7.24±1.4, III= 7.78±1.2, IV= 8. Mean ± SD of Multi quick score: grade I= 9± 5.6, II= 11.38±5, III =12.89±4.7, IV= 12. (Aqs Vs H- Score: r = 0.701, P < 0.007), (Mqs Vs H-Score: r = 0.808, P < 0.001)
Conclusion: P504S is one of the important immunohistochemical markers in primary and metastatic RCC. Our results show that there is no statistically correlation between histological grade of RCC and AMACR staining in semi – quantitative measurement. We suggest AMACR staining to be used as a diagnostic immunohistochemical marker in conjunction with other markers in differential diagnosis of metastatic renal papillary and even clear cell carcinoma.
Sakineh Amouian; Mahdi Farzadnia; Bahram Memar; Armin Attaranzadeh; Naser Tayyebi
Volume 3, Issue 1 , January 2008, , Pages 25-29
Abstract
Background and Objective: Evaluation of tumor proliferative activity may provide a predicting parameter to estimate biologic aggression and a subsequent prognosis that has been evaluated in many malignancies. We have selected renal cell carcinoma (RCC) in this study. To determine tumor proliferative ...
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Background and Objective: Evaluation of tumor proliferative activity may provide a predicting parameter to estimate biologic aggression and a subsequent prognosis that has been evaluated in many malignancies. We have selected renal cell carcinoma (RCC) in this study. To determine tumor proliferative activity, KI67 antibody was applied and results were compared with apoptosis, applying P53 antibody and using immunohistochemical staining. Patients and Methods: Specimens of 30 patients who underwent radical nephrectomy for RCC were selected for histopathology and immunohistochemical study. Two different grading systems (S&H, Fuhrman) were used to calibrate average nucleoli diameter and tumor grading on all specimens. After processing of paraffin-embedded samples, they were immunohistochemically stained applying (MIB-1) KI67 monoclonal and P53 antibodies. Then, statistical analysis was done. Results: Tumor grading correlated with the average nucleus diameter. Positive reaction to KI67 and P53 antibodies in tumors increased as compared to control group. No significant relationship between age, sex and tumor grade was obtained. Conclusion: These two antibodies are as easy and reliable markers that could be applied on formalin-fixed tissues for better assessment of the biologic behavior of RCC and probably prediction of patients’ outcome.
Mahmoud Kabiri; Mehrdad Mohammadi Sichani; Mohammad Reza Mohajery; Diana Taheri; Ali Chehrei
Volume 1, Issue 2 , April 2006, , Pages 75-80
Abstract
Background and Objectives: RCC is one of the most common genitourinary cancers. Accurate prediction of prognosis would be valuable for adjuvant trial design, counseling and effectively scheduling follow up visits. P53 is a tumor suppressor gene that expresses a protein that involved in both cell-cycle ...
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Background and Objectives: RCC is one of the most common genitourinary cancers. Accurate prediction of prognosis would be valuable for adjuvant trial design, counseling and effectively scheduling follow up visits. P53 is a tumor suppressor gene that expresses a protein that involved in both cell-cycle arrests after DNA damage and apoptosis. Presence of mutated p53 protein in tumors has been related to poor prognosis in several malignancies such as lung, breast and prostate cancer. There is diverging results concerning the prognostic significance of mutated p53 in RCC. The aim of this study was to investigate the survival rate of RCC and the role of inactivated p53 protein as a prognostic marker in RCC. Materials and Methods: Patients with nonmetastatic renal cell carcinoma were studied. Paraffin embedded specimens of patients who underwent surgery between 1994 and 2004 at our department were chosen. All specimens were reevaluated with regard to pathological stage, nuclear grade, histological subtypes and P53 expression. P53 expression was semiquantitively evaluated on paraffin-embedded tumor tissue by immunohistochemistry. The prognostic value of parameters was tested using Kaplan Meier plots by the log rank test and Cox regression analysis. Results: This study performed on paraffin-embedded specimens of patients with nonmetastatic RCC who underwent surgery between 1994 and 2004 at our department. The mean age was 52.64yr (SD: 13.49). Mean tumor size was 7.95cm (SD: 4.00). Pathological stage was I in18 (39.1%), stage II in 10(21.7%), stage III and IV in 18(39.1%) patients. Analysis revealed that 16 lesions were grade I (34.7%), 21(45.65%) grade 2, and 9(19.56%) grades 3and 4. The 10-year total survival of patients was 69.44%. In 28.3% of cases P53 staining was positive. In bivariate analysis tumor stage, tumor size, nuclear grade and P53 expression were not found to be significant prognostic factors. Conclusion: P53 can not be considered as a useful prognostic parameter in renal cell carcinoma.