[Putative chromophobe cell renal carcinoma: are they or are they not?]. / Carcinomas renales de células cromófobas putativos: son o no son?

OBJECTIVE: According to the literature, the typical histological findings and simple colloidal iron staining permit the identification of chromophobe cell renal carcinoma, a genetically well-established entity. Our doubts on whether this tumor type can be recognized by conventional methods are presented in this study. METHODS: 130 cases of renal carcinoma were treated from 1977 to 1997. Of these, 12 showed characteristic general histological features compatible with chromophobe cell renal carcinoma and reticulated and intense, diffuse cytoplasmic positivity on colloidal iron staining. These tumors were reviewed for the following: 1) gross appearance, 2) architecture, 3) cytoplasmic characteristics, 4) nuclear characteristics, 5) colloidal iron histochemical staining which is considered fundamental and exclusive, 6) immunohistochemical phenotype. Ultrastructural study of material fixed in paraffin was also performed. RESULTS: One case met all 6 criteria, 3 met 5 of them, 6 cases met 4, and 2 cases met 3 of the criteria. The ultrastructural study was not useful in making the diagnosis due to the poor quality of the material. CONCLUSIONS: If all cases were chromophobe cell renal carcinoma, then this tumor type can be recognized and diagnosed by simple techniques in any pathology laboratory, and its incidence, presence of necrosis, hemorrhage and high nuclear grade would be even greater than currently accepted. Furthermore, it would be expected that the prognosis, by each grade and stage, would not be so different from that of the conventional renal carcinoma, as some large series have already indicated. On the other hand, if our cases or some of them were in fact conventional renal cell carcinoma that closely resembled chromophobe cell renal carcinoma, an exact diagnosis cannot be made without a genetic or ultrastructural study (using adequately fixed material), and most of the published studies would therefore have to be questioned.

[Sclerosing adenosis of the prostate]. / Adenosis esclerosante de la próstata.

OBJECTIVES: To describe the anatomoclinical characteristics of 4 cases of sclerosing adenosis of the prostate in order to determine the diagnostic features and clinical significance of this disease entity, which histologically mimicks adenocarcinoma of the prostate. METHODS: Specimens from our Pathological Anatomy Service obtained by transurethral resection (TUR) and prostatic adenomectomy, with a clinical diagnosis of a benign pathology, were reviewed. Three cases with a histological diagnosis of sclerosing adenosis of the prostate were found over the last 10 years. A fourth case, an adenomectomy specimen corresponding to 1986 whose initial diagnosis had been changed to that of sclerosing adenosis of the prostate, was identified in a review conducted on incidentally detected carcinomas Tla. RESULTS: The four cases (2 adenomectomy, 2 TUR specimens) were microscopic findings. Patient mean age was 73 years. All cases were associated with a nodular hyperplasia, without clinical or analytical signs of malignant neoplasm or an associated carcinoma. One case showed involvement of 3 fragments of the TUR specimen; the rest had a single focus or involvement of a single fragment. At 5 years mean follow-up, no evidence of new lesions have been observed. CONCLUSIONS: Sclerosing adenosis of the prostate is an uncommon lesion, which is generally microscopic and more frequently found in the prostatic transitional zone, and can be confused histologically with microacinar carcinoma. It is usually an incidental histopathological finding without clinical significance or relationship with carcinoma of the prostate.