Skip to main content

CT and MR imaging features of mucinous tubular and spindle cell carcinoma of the kidneys. A multi-institutional review

European Radiology volume 27, pages 1087–1095 (2017)Cite this article

Abstract

Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney is a recently identified renal malignancy. Diagnosis of this rare subtype of renal tumour can be challenging for pathologists, and as such, any additional data would be helpful to improve diagnostic reliability. As imaging features of this new and rare sub-type have not yet been clearly described, the purpose of this study was to describe the main radiologic features on computed tomography (CT) and magnetic resonance imaging (MRI), based jointly on the literature and findings from a multi-institutional retrospective review of pathology and imaging databases. Using a combination of CT/MRI features, diagnosis of MTSCC could be suggested in many cases. A combination of slow enhancement with plateau on dynamic contrast-enhanced CT/MRI, intermediate to high T2 signal intensity contrasting with low apparent diffusion coefficient values on MRI appeared evocative of this diagnosis.

Key Points

• A slow enhancement with plateau is observed either on CT or MRI.

• High T2 signal components but low apparent coefficient diffusion are evocative.

• T2-weighted imaging features depend on the mucin components of the tumour.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price includes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Abbreviations

ADC:

apparent diffusion coefficient

CEUS:

contrast-enhanced ultrasound

CT:

computed tomography

DCE:

dynamic contrast-enhanced

GE:

gradient echo

Gd:

gadolinium

MR:

magnetic resonance

MTSCC:

mucinous tubular and spindle cell carcinoma

RCC:

renal cell carcinoma

ROI:

region of interest

US:

ultrasound

References

  1. Lechevallier E, Andre M, Barriol D et al (2000) Fine-needle percutaneous biopsy of renal masses with helical CT guidance. Radiology 216:506–510

    CAS  Article  PubMed  Google Scholar 

  2. Atri M, Tabatabaeifar L, Jang HJ, Finelli A, Moshonov H, Jewett M (2015) Accuracy of contrast-enhanced us for differentiating benign from malignant solid small renal masses. Radiology 276:900–908

    Article  PubMed  Google Scholar 

  3. Cornelis F, Tricaud E, Lasserre AS et al (2014) Routinely performed multiparametric magnetic resonance imaging helps to differentiate common subtypes of renal tumours. Eur Radiol 24:1068–1080

    CAS  Article  PubMed  Google Scholar 

  4. Schieda N, van der Pol CB, Moosavi B, McInnes MD, Mai KT, Flood TA (2015) Intracellular lipid in papillary renal cell carcinoma (pRCC): T2 weighted (T2W) MRI and pathologic correlation. Eur Radiol 25:2134–2142

    Article  PubMed  Google Scholar 

  5. Karlo CA, Di Paolo PL, Chaim J et al (2014) Radiogenomics of clear cell renal cell carcinoma: associations between CT imaging features and mutations. Radiology 270:464–471

    Article  PubMed  Google Scholar 

  6. Karlo CA, Di Paolo PL, Donati OF et al (2013) Renal cell carcinoma: role of MR imaging in the assessment of muscular venous branch invasion. Radiology 267:454–459

    Article  PubMed  Google Scholar 

  7. Vargas HA, Chaim J, Lefkowitz RA et al (2012) Renal cortical tumors: use of multiphasic contrast-enhanced MR imaging to differentiate benign and malignant histologic subtypes. Radiology 264:779–788

    Article  PubMed  Google Scholar 

  8. Young JR, Margolis D, Sauk S, Pantuck AJ, Sayre J, Raman SS (2013) Clear cell renal cell carcinoma: discrimination from other renal cell carcinoma subtypes and oncocytoma at multiphasic multidetector CT. Radiology 267:444–453

    Article  PubMed  Google Scholar 

  9. Srigley JR, Delahunt B, Eble JN et al (2013) The International Society of Urological Pathology (ISUP) vancouver classification of renal neoplasia. Am J Surg Pathol 37:1469–1489

    Article  PubMed  Google Scholar 

  10. Shen SS, Ro JY, Tamboli P et al (2007) Mucinous tubular and spindle cell carcinoma of kidney is probably a variant of papillary renal cell carcinoma with spindle cell features. Ann Diagn Pathol 11:13–21

    Article  PubMed  Google Scholar 

  11. Becht E, Giraldo NA, Beuselinck B et al (2015) Prognostic and theranostic impact of molecular subtypes and immune classifications in renal cell cancer (RCC) and colorectal cancer (CRC). Oncoimmunology 4:e1049804

    Article  PubMed  PubMed Central  Google Scholar 

  12. Beuselinck B, Jean-Baptiste J, Couchy G et al (2015) RANK/OPG ratio of expression in primary clear-cell renal cell carcinoma is associated with bone metastasis and prognosis in patients treated with anti-VEGFR-TKIs. Br J Cancer 113:1313–1322

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  13. Beuselinck B, Job S, Becht E et al (2015) Molecular subtypes of clear cell renal cell carcinoma are associated with sunitinib response in the metastatic setting. Clin Cancer Res 21:1329–1339

    CAS  Article  PubMed  Google Scholar 

  14. Kenney PA, Vikram R, Prasad SR et al (2015) Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney: a detailed study of radiological, pathological and clinical outcomes. BJU Int 116:85–92

    Article  PubMed  Google Scholar 

  15. Ferlicot S, Allory Y, Comperat E et al (2005) Mucinous tubular and spindle cell carcinoma: a report of 15 cases and a review of the literature. Virchows Arch 447:978–983

    Article  PubMed  Google Scholar 

  16. Paner GP, Srigley JR, Radhakrishnan A et al (2006) Immunohistochemical analysis of mucinous tubular and spindle cell carcinoma and papillary renal cell carcinoma of the kidney: significant immunophenotypic overlap warrants diagnostic caution. Am J Surg Pathol 30:13–19

    Article  PubMed  Google Scholar 

  17. Luciani LG, Cestari R, Tallarigo C (2000) Incidental renal cell carcinoma-age and stage characterization and clinical implications: study of 1092 patients (1982-1997). Urology 56:58–62

    CAS  Article  PubMed  Google Scholar 

  18. Zhu Q, Zhu W, Wang Z, Wu J (2014) Clinical and CT imaging features of mucinous tubular and spindle cell carcinoma. Chin Med J (Engl) 127:1278–1283

    Google Scholar 

  19. Ordonez NG, Mackay B (1996) Renal cell carcinoma with unusual differentiation. Ultrastruct Pathol 20:27–30

    CAS  Article  PubMed  Google Scholar 

  20. MacLennan GT, Farrow GM, Bostwick DG (1997) Low-grade collecting duct carcinoma of the kidney: report of 13 cases of low-grade mucinous tubulocystic renal carcinoma of possible collecting duct origin. Urology 50:679–684

    CAS  Article  PubMed  Google Scholar 

  21. MacLennan GT, Bostwick DG (2005) Tubulocystic carcinoma, mucinous tubular and spindle cell carcinoma, and other recently described rare renal tumors. Clin Lab Med 25:393–416

    Article  PubMed  Google Scholar 

  22. Pillay N, Ramdial PK, Cooper K, Batuule D (2008) Mucinous tubular and spindle cell carcinoma with aggressive histomorphology--a sarcomatoid variant. Hum Pathol 39:966–969

    Article  PubMed  Google Scholar 

  23. Ito T, Pei J, Dulaimi E et al (2015) Genomic copy number alterations in renal cell carcinoma with sarcomatoid features. J Urol. doi:10.1016/j.juro.2015.10.180

  24. Thway K, du Parcq J, Larkin JM, Fisher C, Livni N (2012) Metastatic renal mucinous tubular and spindle cell carcinoma. Atypical behavior of a rare, morphologically bland tumor. Ann Diagn Pathol 16:407–410

    Article  PubMed  Google Scholar 

  25. Ursani NA, Robertson AR, Schieman SM, Bainbridge T, Srigley JR (2011) Mucinous tubular and spindle cell carcinoma of kidney without sarcomatoid change showing metastases to liver and retroperitoneal lymph node. Hum Pathol 42:444–448

    Article  PubMed  Google Scholar 

  26. Wu J, Zhu Q, Zhu W, Chen W, Wang S (2015) Comparative study of CT appearances in mucinous tubular and spindle cell carcinoma and collecting duct carcinoma of the kidney. Br J Radiol 88:20140434

    Article  PubMed  PubMed Central  Google Scholar 

  27. Noon AP, Smith DJ, McAndrew P (2010) Magnetic resonance imaging characterization of a mucinous tubular and spindle cell carcinoma of the kidney detected incidentally during an ectopic pregnancy. Urology 75:247–248

    Article  PubMed  Google Scholar 

  28. Tirumani SH, Assiri YI, Brimo F, Tsatoumas M, Reinhold C (2013) Diffusion-weighted MR imaging of mucin-rich mucinous tubular and spindle cell carcinoma of the kidney: a case report. Clin Imaging 37:775–777

    Article  PubMed  Google Scholar 

  29. Yasufuku T, Shigemura K, Fujisawa M (2009) Mucinous tubular and spindle cell carcinoma. Int J Urol 16:425–426

    Article  PubMed  Google Scholar 

  30. Sahni VA, Hirsch MS, Sadow CA, Silverman SG (2012) Mucinous tubular and spindle cell carcinoma of the kidney: imaging features. Cancer Imaging 12:66–71

    Article  PubMed  Google Scholar 

  31. Maeda M, Matsumine A, Kato H et al (2007) Soft-tissue tumors evaluated by line-scan diffusion-weighted imaging: influence of myxoid matrix on the apparent diffusion coefficient. J Magn Reson Imaging 25:1199–1204

    Article  PubMed  Google Scholar 

  32. Sun MRM, Ngo L, Genega EM et al (2009) Renal cell carcinoma: dynamic contrast-enhanced MR imaging for differentiation of tumor subtypes--correlation with pathologic findings. Radiology 250:793–802

    Article  PubMed  Google Scholar 

  33. Pedrosa I, Sun MR, Spencer M et al (2008) MR imaging of renal masses: correlation with findings at surgery and pathologic analysis. Radiographics 28:985–1003

    Article  PubMed  Google Scholar 

  34. Roy C, Sauer B, Lindner V, Lang H, Saussine C, Jacqmin D (2007) MR Imaging of papillary renal neoplasms: potential application for characterization of small renal masses. Eur Radiol 17:193–200

    Article  PubMed  Google Scholar 

  35. Yoshimitsu K, Irie H, Tajima T et al (2004) MR imaging of renal cell carcinoma: its role in determining cell type. Radiat Med 22:371–376

    PubMed  Google Scholar 

  36. Hindman N, Ngo L, Genega EM et al (2012) Angiomyolipoma with minimal fat: can it be differentiated from clear cell renal cell carcinoma by using standard MR techniques? Radiology 265:468–477

    Article  PubMed  PubMed Central  Google Scholar 

  37. Oliva MR, Glickman JN, Zou KH et al (2009) Renal cell carcinoma: t1 and t2 signal intensity characteristics of papillary and clear cell types correlated with pathology. AJR 192:1524–1530

    Article  PubMed  Google Scholar 

  38. Wang H, Cheng L, Zhang X et al (2010) Renal cell carcinoma: diffusion-weighted MR imaging for subtype differentiation at 3.0 T. Radiology 257:135–143

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The scientific guarantor of this publication is Pr Nicolas Grenier. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, observational, multicenter study.

Author information

Authors and Affiliations

  1. Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France

    F. Cornelis & N. Grenier

  2. Department of Pathology, Pasteur Hospital, 30 av. de la Voie Romaine, 06002, Nice, France

    D. Ambrosetti

  3. Department of Radiology, Kremlin-Bicêtre Hospital, 78 rue du Général Leclerc, 94275, Paris, France

    L. Rocher

  4. Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU Ospedale, San Martino IST, Largo R. Benzi, 10, I-16132, Genoa, Italy

    L. E. Derchi

  5. Department of Radiology, Claude Huriez Hospital, 1 place de Verdun, 59037, Lille, France

    B. Renard & P. Puech

  6. Department of Radiology, Brabois Hospital, rue du Morvan, 54511, Vandoeuvre-lès-Nancy, France

    M. Claudon

  7. Department of Radiology, E. Herriot Hospital, 5 Place d’Arsonval, 69437, Lyon, France

    O. Rouvière

  8. Department of Pathology, Kremlin-Bicêtre Hospital, 78 rue du Général Leclerc, 94275, Paris, France

    S. Ferlicot

  9. Department of Radiology, Civil Hospital, 1 place de l’Hôpital, 67091, Strasbourg, France

    C. Roy

  10. Department of Pathology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France

    M. Yacoub

  11. Department of Urologic Surgery, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France

    J. C. Bernhard

Authors
  1. F. Cornelis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. Ambrosetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. Rocher
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L. E. Derchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. Renard
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. P. Puech
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Claudon
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. O. Rouvière
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. S. Ferlicot
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. C. Roy
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. M. Yacoub
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. N. Grenier
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. J. C. Bernhard
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F. Cornelis.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Cornelis, F., Ambrosetti, D., Rocher, L. et al. CT and MR imaging features of mucinous tubular and spindle cell carcinoma of the kidneys. A multi-institutional review. Eur Radiol 27, 1087–1095 (2017). https://doi.org/10.1007/s00330-016-4469-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-016-4469-1

Keywords

  • Kidney
  • Tumour
  • Magnetic resonance imaging
  • Renal cell carcinoma
  • Mucinous tubular and spindle cell carcinoma of kidney