Clinicopathological analysis of papillary renal cell carcinoma / 解放军医学杂志

ABSTRACT

Objective To investigate the histological features of papillary renal cell carcinoma, and to explore the relationship between nuclear grading and prognosis. Methods The pathological slides and clinical data of 13 cases of papillary renal cell carcinoma were reviewed. The pathological features were scrutinized and nuclear grading was conducted according to Fuhrman grading system. Immunohistochemical staining for CK7, EMA, and vimentin was also respectively done. The correlation between nuclear grade and prognosis was analysed. Results The age range of the patients was from 35 to 67 (average 53) years. 10 were male and 3 were female. Most of the tumors were located in the upper pole (5cases) or lower pole (5cases). Three were located in the middle part of the kidney, with some inclination to either pole. All the tumors were well circumscribed with a size ranged from 2cm to 6.3cm (average 3.5cm) in diameter. Hemorrage and cystic change were obviously seen in large tumors. Microscopically, the tumors were composed of papillary or tubular structures, with hemorrhage, foamy macrophages and cystic change as prominent features. 6 cases were multifocal. Fuhrman nuclear grade Ⅰ or Ⅱ was made in 6 cases, and Ⅲ or Ⅳ in 7 cases. All the tumors were positive for CK7, EMA and vimentin. The patients were followed up for 28 to 102 months (average 52 months). 3 patients died of tumor recurrence or metastasis after the operation at 36, 41 and 50 months, respectively, while others survived without tumor up to now. The three dead patients were graded Ⅲ or Ⅳ by Fuhrman nuclear grading system. Conclusion Papillary renal cell carcinoma was different from other renal carcinoma variants in that they, usually have a better prognosis.