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Objective To investigate the imaging features and the relationship with pathological characteristics of chromophobe cell renal carcinoma (CCRC).Methods The clinicopatholocal manifestations and CT or MRI imaging findings were analyzed retro-spectively in 23 patients with surgically confirmed CCRC.The location,shape,size,density,border,blood supply and invasion of adjacent organs of CRCC,especially the dynamic enhanced mode,were mainly analyzed and compared with pathology.Results The 23 cases of CCRC showed unilateral single mass on CT and MRI scans,and 12 located in right kidney while 1 1 in left kidney.The size ranged from 27-330 mm in diameter,and round or oval-shaped soft tissue mass was observed.The boundaries of 1 6 cases were clear,and 3 cases of mass broke through renal capsule,3 invaded renal pelvis,perirenal fat,renal vein and inferior vena cava,2 ca-ses with retroperitoneal lymph node metastases.18 cases were scanned by CT and the mass presented as soft tissue density on plain CT (CT value 30-44 HU).6 cases were scanned by MRI with abnormalities presenting with iso or hypo-intense on the T1 WI,hy-per or hypo-intense on the T2 WI,and 2 cases of pseudocapsule were showed as circled hypointense on T2 WI.According to the dy-namic enhancement,23 cases of CCRC were divided into three type:(1 )Mild-to-moderate enhanced type(n= 14):including mild homogeneous strengthening (n=7)and mild heterogeneous strengthening (n=7);(2)Significantly enhanced type(n=7):including heterogeneous enhancement(n=6)and uniform enhancement(n=1);(3)Spokes shape or scar enhancement(n=2).The sample of CCRC was mainly solid and showed yellowish-brown or brown section.According to the situation of HE staining,the characteristic microscopic features were divided into three types:the typical,acidophil type and mixed type.Conclusion Combined imaging find-ings of CT dynamic enhanced mode can provide characteristic information for diagnosis of CCRC,and comprehensive analysis of the imaging findings will contribute to the diagnosis and differential diagnosis.
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Purpose To explore the multislice spiral CT (MSCT) features of renal chromophobe carcinoma, and to improve the understanding and diagnosis of the disease. Materials and Methods MSCT features of 17 patients with renal chromophobe carcinoma confirmed by surgical pathology were retrospectively analyzed, plain MSCT and multi-phase dynamic contrast-enhanced scan were applied to these patients. Results Single substantive round or oval-shaped soft tissue mass was demonstrated in 17 cases. The lesions were all uniform density on plain MSCT, and mild to moderate homogeneous enhancement in 11 cases on enhanced MSCT, including 9 cases with significant enhancement above the renal medulla and below the renal cortex, and 2 cases with similar enhancement to renal medulla in corticomedullary phase. On nephrographic phase the lesion showed significant lower density than renal medulla. Heterogeneous enhancement presented in 6 cased, including 1 case with small necrosis and 1 case with stellate scar lesion in low-density. Conclusion Renal chromophobe carcinoma demonstrates a round solid mass of uniform density on plain MSCT, and mild to moderate homogeneous and heterogeneous, which can provide the reference value for preoperative diagnosis.
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Objective To evaluate the clinical characteristic,diagnosis and treatment procedures for renal oncocytoma and chromophobe cell renal carcinoma.Methods Eight cases of renal oncocytoma and 5 cases of chromophobe cell renal carcinoma were analysed.The average of oncocytoma was 58.8 years old(23～74),and mean tumor size was 5.1 cm(range,3～7 cm);The mean age of chromophobe cell renal carcinoma was 54.5 years old(35～72),and mean tumor size was 5.8 cm(range,3～8 cm).Doppler ultrasonography and CT scan were performed in all patients.All cases accepted surgical operation and were confirmed by pathology.Results Renal oncocytoma was characterized by homogeneous round cell containing aboundant axyphil pellets.Color Doppler ultrasonography show isoechoic or hypoechoic masses.CT scan revealed that the tumors were homogeneous solid masses,and most of them were visualized as homogeneous enhancement.All the patients were followed up for 10 to 53 months,and no recurrence or metastasis was noted.Color Doppler ultrasonography show mainly hyperechoic masses,CT scan revealed most of the tumors were heterogeneous enhancement.All the patients were followed up for 12 to 49 months,and 1 case died from metastasis after 1 year.Conclusion Renal oncocytoma and chromophobe cell renal carcinoma can be differentiated by clinical characteristic,ultrasonic and CT scan examination.The diagnosis is confirmed by pathology.Partial nephrectomy is good for renal oncocytoma,while radical nephrectomy is still the first choice for chromophobe cell renal carcinoma.
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Objective To analyze and compare the imaging features of chromophobe cell renal carcinoma(CCRC)with pathologic findings in order to improve the diagnostic accuracy.Methods The data of CT and MRI of 12 patients with CCRC were reviewed retrospectively.Ten patients underwent CT examination,including precontrast scan,the contrast eortieomedullary phase scan and the parenchymal phase scan(one patient without corticomedullary phase scan).Two patients underwent MR examination including precontrast T_1WI,T_2WI and enhanced T_1WI of the corticomedullary phase and the parenchymal phase.Results Four lesions located in left kidney and eight in right kidney.Maximum diameter of lesions ranged from 24 mm to 125 mm,average 56.7 ram.Homogenous density was observed in six lesions of ten on unenhanced CT scan and five lesions had homogenous enhancement on enhanced CT scan,which was due to the less incidence of necrosis,liquefaction and hemorrhage on pathologic findings.Nine Lesions showed hyperdense compared with renal medulla but the density was lower than renal cortex on the corticomedullary phase.The enhanced degree was positively correlated with microvessel density(MVD).All ten lesions became hypodense compared with renal medulla on the parenchymal phase scan.Central stellate scar was found in two big lesions and psudocapsula were observed in four lesions confirmed by pathology.Two patients underwent MRI examination.Compared with medulla,the two lesions showed hyperintense on unenhanced T_1WI and obviously hypointense on unenhaneed T_2WI.The enhancement pattern of them was similar to CT. Conclusion The imaging features of CCRC,such as homogeneity,special enhancement pattern and distinct hypointensity on T_2WI,help to differentiate CCRC from other renal tumors.
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We present four cases of the recently characterized chromophobe cell renal carcinoma. Gross hematuria, palpable flank mass and flank pain were the main symptoms of patients. With chromophobe cell renal carcinoma all tumors were solitary pale brown or beige colored mass, ranging from 6.0 to 10.5cm in diameter. Microscopically two cases were typical type and the other two cases were eosiophilic type. All of them showed strong reactivity for Hale's colloidal iron stain, cytokeratin and epithelial membrane antigen, but negative for vimentin. Ultrastructually characteristic invaginated microvesicles, 180-440nm in diameter, were identified in the cytoplasm. DNA ploidy studies revealed an aneuploid cell population in two cases of eosinophilic type. No patients showed recurrent tumor during the follow up periods, ranging from 5 to 92months.
Subject(s)
Humans , Aneuploidy , Colloids , Cytoplasm , DNA , Eosinophils , Flank Pain , Flow Cytometry , Follow-Up Studies , Hematuria , Iron , Keratins , Microscopy, Electron , Mucin-1 , Ploidies , VimentinABSTRACT
Chromophobe cell renal carcinoma is an uncommon variety of renal cell carcinoma first described in humans in 1985 by Thoenes and his colleagues. It is a distinct type of renal cancer presumably derived from the intercalated cells of the collecting duct system and exhibiting a better prognosis than other types of renal cell carcinoma. This type of renal cell carcinoma has not been reported in Korean literature. We experienced three cases of chromophobe cell renal carcinoma from surgical pathology files of Dong-A medical center. The patients were a 65-year-old female, a 54-year-old female, and a 50-year-old male who had 8.2x6 cm, 4x2.5 cm and 4.3x3.2 cm sized, yellowish gray, beige to tan colored masses in the kidneys, respectively. Microscopically, the tumor cells were arranged in sheets or nests with delicate intervening vasculature. The cells were voluminous, uniform in appearance and contained finely reticulated cytoplasms delineated by prominent cell borders. With Hale's iron colloid staining the cytoplasm showed positive reaction; with PAS staining the result was negative. Immunohistochemically, the tumor cells showed positive reaction for cytokeratin but negative for vimentin. Electron microscopy showed numerous small, round to oval cytoplasmic vesicles, 150-300nm in size. All the patients received only radical nephrectomy and survived without evidence of recurrence or metastasis during follow-up intervals ranging from 4 months to 5 years.