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Muzinöses, tubuläres und spindelzelliges Nierenkarzinom

Eine molekulare Analyse

  • Schwerpunkt: Uropathologie—Originalarbeit
  • Published:
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Zusammenfassung

Die neue WHO-Klassifikation beschreibt verschiedene neue Subtypen von Nierentumoren. Eine neue Entität sind die niedrig malignen Nierenkarzinome mit muzinösem, tubulärem und spindelzelligem Wachstum. Morphologisch charakteristisch für diesen Tumortyp sind Zellen mit geringen Kernatypien und eosinophilem, manchmal auch klarzelligem Zytoplasma. Es wurde postuliert, dass dieser Tumor entweder vom Sammelrohr oder von der Henle-Schleife abstammt.

In der vorliegenden Untersuchung wurden 21 dieser Tumoren immunhistochemisch und molekulargenetisch untersucht. Es zeigten sich komplexe DNA-Sequenz-Veränderungen mit einer sehr hohen Anzahl genomischer Veränderungen. Die immunhistologischen Untersuchungen belegen einen komplexen Immunphänotyp, der einen Ursprung aus der Henle-Schleife jedoch nicht eindeutig beweist. Die bisher beobachteten klinischen Verläufe sprechen für einen Tumor von allenfalls niedrigem Malignitätsgrad. Insgesamt wird damit ein Nierentumor mit besonderer Morphologie beschrieben, der keine Beziehung zu klarzelligen Nierenkarzinomen aufweist und dessen Histogenese noch nicht vollständig aufgeklärt ist.

Abstract

The new WHO-classification of renal tumors includes new subtypes, one of which is the mucinous, tubular, and spindle cell carcinoma. Many of these tumors had been previously diagnosed as sarcomatoid carcinoma. There are areas of cord-like growth and spindle cell configuration, sometimes with a clear cell appearance. The cells have low-grade nuclear features. It has been postulated that these tumors are related to the loop of Henle. In this study, 21 tumors were immunohistochemically and genetically analyzed. The analysis showed complex genomic aberrations, but no chromosome 3p losses. Fluorescence in situ hybridization detected no von Hippel-Lindau gene deletions on chromosome 3p25, which are characteristic for clear cell renal carcinomas. These findings show that there is no genetic relationship to clear cell renal carcinomas. The results of the immunohistochemical analyses showed a complex immunophenotype, but could not prove a derivation from the loop of Henle. The prognosis of these tumors seems to be favorable.

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Danksagung

Die Autoren danken Carole Egenter für die Mithilfe bei der Auswertung der CGH-Ergebnisse, Hedwika Novotny für die Durchführung der FISH-Untersuchungen sowie Frau Epper und Frau Griesshaber für die immunhistochemischen Untersuchungen.

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Authors and Affiliations

  1. Institut für Pathologie, Universität Basel, Schweiz

    A. Weber &  H. Moch

  2. Credit Valley Hospital, Mississauga, Ontario, Kanada

    J. Srigley

  3. Institut für Pathologie, Universität Basel, Schönbeinstraße 40, 4031, Basel, Schweiz

    H. Moch

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  1. A. Weber
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  2. J. Srigley
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  3. H. Moch
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Correspondence to H. Moch.

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Weber, A., Srigley, J. & Moch, H. Muzinöses, tubuläres und spindelzelliges Nierenkarzinom. Pathologe 24, 453–459 (2003). https://doi.org/10.1007/s00292-003-0657-2

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