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Virchows Archiv

, Volume 469, Issue 1, pp 71–80 | Cite as

“Mucin”-secreting papillary renal cell carcinoma: clinicopathological, immunohistochemical, and molecular genetic analysis of seven cases

  • Kristyna Pivovarcikova
  • Kvetoslava Peckova
  • Petr Martinek
  • Delia Perez Montiel
  • Kristyna Kalusova
  • Tomas Pitra
  • Milan Hora
  • Faruk Skenderi
  • Monika Ulamec
  • Ondrej Daum
  • Pavla Rotterova
  • Ondrej Ondic
  • Magdalena Dubova
  • Romuald Curik
  • Ana Dunatov
  • Tomas Svoboda
  • Michal Michal
  • Ondrej HesEmail author
Original Article

Abstract

Mucin and mucin-like material are features of mucinous tubular and spindle renal cell carcinoma (MTS RCC) but are rarely seen in papillary renal cell carcinoma (PRCC). We reviewed 1311 PRCC and identified 7 tumors containing extracellular and/or intracellular mucinous/mucin-like material (labeled as PRCCM). We analyzed these using morphological, histochemical, immunohistochemical, and molecular genetic methods (arrayCGH, FISH). Clinical data were available for six of the seven patients (five males and one female, age range 61–78 years). Follow-up was available for four patients (2–4 years); one patient died of widespread metastases. Tumor size ranged from 3 to 5 cm (mean 3.8). Of all cases, histological architecture showed a predominantly papillary pattern. Mucin or mucin-like was extracellular in one, intracellular in three, and both intra/extracellular in three cases. All tumors were positive for AMACR, vimentin, and OSCAR, while CK7 was positive in four. Mucicarmine stain was positive in all cases, PAS in six and Alcian blue in three cases. Five tumors were positive for MUC 1, but none were positive for MUC 2, MUC 4, or MUC 6. In only four cases, genetic analysis could be performed. Gain of chromosomes 7 and 17 was found in two cases; gain of 17 only was found in one case. Loss of heterozygosity of 3p was found in one case together with polysomy of chromosomes 7 and 17. No abnormalities of VHL, fumarate dehydrogenase, and TFE3 genes were detected. We conclude that PRCCM is a rare but challenging subtype of RCC that deserves to be further studied. In all the tumors, the mucin-like material was found in those stained with mucicarmin, but other conventional and immunohistochemical stains did not reveal consistent features of a single mucin. The molecular-genetic profile of these tumors was most consistent with that of typical papillary RCC, although one case had mixed genetic features of papillary and clear RCC. PRCCM has metastatic potential, as evidenced by one case with widespread metastases. It remains to be determined whether PRCCM represents a unique tumor subtype, deserving to be distinguished from other subtypes of PRCC.

Keywords

Kidney Papillary renal cell carcinoma Mucin Mucin-like secretion Immunohistochemistry Array CGH FISH 

Notes

Acknowledgments

The authors thank Dr. Ivan Damjanov for his help with the editing of our paper and for the constructive discussion.

Compliance with ethical standards

The study was approved by local Ethics Committee (Medical Teaching Hospital and Medical School of Charles University in Plzen).

Funding

The study was supported by the Charles University Research Fund (project number P36), by the project CZ.1.05/2.1.00/03.0076 from European Regional Development Fund, and by SVV 260283.

Conflict of interest

The authors declare no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Kristyna Pivovarcikova
    • 1
  • Kvetoslava Peckova
    • 1
  • Petr Martinek
    • 1
  • Delia Perez Montiel
    • 2
  • Kristyna Kalusova
    • 3
  • Tomas Pitra
    • 3
  • Milan Hora
    • 3
  • Faruk Skenderi
    • 4
  • Monika Ulamec
    • 5
  • Ondrej Daum
    • 1
  • Pavla Rotterova
    • 1
  • Ondrej Ondic
    • 1
  • Magdalena Dubova
    • 1
  • Romuald Curik
    • 1
  • Ana Dunatov
    • 6
  • Tomas Svoboda
    • 7
  • Michal Michal
    • 1
  • Ondrej Hes
    • 1
    • 8
    Email author
  1. 1.Department of Pathology, Medical FacultyCharles University and Charles University Hospital PlzenPilsenCzech Republic
  2. 2.Department of PathologyInstituto Nacional de CancerologiaMexico CityMexico
  3. 3.Department of Urology, Medical FacultyCharles University and Charles University Hospital PlzenPragueCzech Republic
  4. 4.Department of PathologyUniversity Hospital SarajevoSarajevoBosna and Hercegovina
  5. 5.Pathology Department, Clinical Hospital CenterSestre milosrdniceZagrebCroatia
  6. 6.Department of PathologyUniversity Hospital SplitSplitCroatia
  7. 7.Department of Oncology, Medical FacultyCharles University and Charles University Hospital PlzenPragueCzech Republic
  8. 8.Biomedical Centre, Faculty of Medicine in PlzenCharles University in PraguePlzenCzech Republic

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