Original ContributionsLow-grade myxoid renal epithelial neoplasms with distal nephron differentiation
Section snippets
Case identification and review
The two initial cases in the study were identified in the consultation files of 1 of the authors (J.B.B.). The files of 2 authors (J.B.B., J.I.E.) were then searched electronically for morphologically similar cases using the key words “carcinoma,” “Henle,” and “collecting duct.” Initial review yielded a total group of 6 morphologically similar cases. After immunohistochemical analysis, 2 cases were eliminated because of disparate immunohistochemical labeling patterns (see Discussion), leaving 4
Clinical and gross features
The clinical and gross features of the 4 cases are summarized in Table 2.Case Age/Sex Clinical Presentation Tumor Diameter/Gross Features Pathologic Stage Clinical Follow-up 1 41/F Abdominal pain and history of UTI→CT scan 2.2 cm/Centered in medulla, yellow-tan pT1 NED, 22 mo 2 48/F Abdominal mass 11 cm/Pink-tan, jellylike with hemorrhage pT2 NED, 6 yr 3 79/F Abdominal pain and hematuria→CT scan 11 cm/Yellow-tan with necrosis and hemorrhage, located centrally in kidney pT2
Discussion
We report a distinct group of 4 renal neoplasms characterized by noninfiltrative borders, myxoid stroma, elongated tubular and cordlike architecture, and low-grade nuclear features. Their clinical follow-up was benign. The differential diagnosis for these tumors includes both benign and highly malignant entities. One one hand, the low cuboidal shape of the tumor cells, their minimal cytoplasm, low nuclear grade, and interanastamosing tubular pattern raise the differential diagnosis of
Acknowledgements
The authors thank the pathologists who provided cases used for this study: Dr Lawrence Wong (Hollywood, FL), Dr Craig Zuppan (Loma Linda, CA), Dr Karen Axelsson (Oakland, CA), Dr Nancy Newton (Riverdale, GA), Dr Warick Delprado (North Ryde, Australia). They thank Dr Selva Murgesan for performing the immunohistochemical stains and Pete Lund for expert photographic assistance. They gratefully acknowledge Dr Raoul Fresco's expertise in performing the electron microscopic examination and providing
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