Background:Erythrocytosis,a rare paraneoplastic syndrome,generally occurs in patients with clear cell renal cell carcinoma and has never been reported in patients with chromophobe renal cell carcinoma.Case presentatio...Background:Erythrocytosis,a rare paraneoplastic syndrome,generally occurs in patients with clear cell renal cell carcinoma and has never been reported in patients with chromophobe renal cell carcinoma.Case presentation:We report a case of a young man suffering from a giant(22-cm) mass on his left kidney.Because of a history of polycythemia vera,the patient had been treated for the condition for 9 years.Radical nephrectomy was successfully performed,and the postoperative pathologic examination confirmed a diagnosis of chromophobe renal cell carcinoma.Unexpectedly,the symptom of erythrocytosis disappeared after the surgery.Further examination and analysis were performed,and we finally attributed his erythrocytosis to chromophobe renal cell carcinoma.Conclusions:Chromophobe renal cell carcinoma could cause erythrocytosis,but the clear-cut mechanism needs further research.Secondary erythrocytosis such as those related with renal tumors should be taken into consideration during the diagnosis of polycythemia vera.展开更多
Chromophobe renal cell carcinoma(ChRCC)is the third most common renal cell carcinoma(RCC)subtype,which predominantly occurs in sporadic setting.ChRCCs are considered to originate from the intercalated cell of distal t...Chromophobe renal cell carcinoma(ChRCC)is the third most common renal cell carcinoma(RCC)subtype,which predominantly occurs in sporadic setting.ChRCCs are considered to originate from the intercalated cell of distal tubules with two main morphological variants,classic and eosinophilic.Most ChRCCs carry a favorable clinical outcome.Histology alone is limited in predicting the behavior of ChRCCs that do not have overtly aggressive morphologic findings such as necrosis and sarcomatoid features.Along with positive CD117 expression,classic ChRCCs generally express diffuse and uniform CK7,while eosinophilic variant demonstrates more heterogeneous CK7 expression(rare or patchy).Multiple losses of chromosomes 1,2,6,10,13,17,and 21 are considered to be the genetic hallmarks of classic and eosinophilic ChRCCs,while chromosomal gains are known to be associated with sarcomatoid ChRCCs.TP53 and PTEN are the two most frequently mutated genes in ChRCCs.The major challenge in the differential diagnosis of ChRCCs includes considerations around the eosinophilic variant(of ChRCCs),where it may share overlapping features with oncocytoma or other recent emergent oncocytic tumors.Most eosinophilic ChRCCs share expression of the recently described biomarkers,LINC01187 and FOXI1,with classic ChRCCs,however,a subset of eosinophilic-like ChRCCs with lower biomarker expression have been demonstrated to harbor MTOR gene mutations.Overall,the morphologic features of ChRCCs and genetic profile with combinations of chromosomal losses and gains suggest this tumor entity to represent a distinct,yet heterogeneous group of renal neoplasms.展开更多
BACKGROUND Renal cell carcinomas are usually unilateral.However,they are bilateral in 2%to 4%of sporadic cases and is considerably more common in familial cases.Synchronous sporadic bilateral multiple chromophobe rena...BACKGROUND Renal cell carcinomas are usually unilateral.However,they are bilateral in 2%to 4%of sporadic cases and is considerably more common in familial cases.Synchronous sporadic bilateral multiple chromophobe renal cell carcinoma(CHRCC)with different subtypes is rare.CASE SUMMARY In this case report,we describe a case of synchronous bilateral CHRCC with two histological variants,accompanied by a clear cell carcinoma and a cyst in a 50-year-old male.The patient underwent retroperitoneal laparoscopic bilateral nephron-sparing surgery and there was no serious postoperative renal dysfunction.CONCLUSION We report a rare case of synchronous bilateral CHRCC with two histological variants associated with a clear cell carcinoma and a cyst.展开更多
Synchronous bilateral multiple chromophobe cell renal carcinoma is rare; here we report a case diagnosed with bilateral renal multiple tumors complicated with a cyst in the right kidney. Retroperitoneal laparoscopic b...Synchronous bilateral multiple chromophobe cell renal carcinoma is rare; here we report a case diagnosed with bilateral renal multiple tumors complicated with a cyst in the right kidney. Retroperitoneal laparoscopic bilateral nephron sparing surgery was performed and there was no serious postoperative renal dysfunction. Pathological and immunohistochemical diagnoses of both tumors were chromophobe cell renal carcinoma. The patient has been doing well without any evidence of recurrence or metastasis for 6 months.展开更多
BACKGROUND There are few reported cases of allograft nephrectomy due to malignancy followed by successful renal re-transplantation two years later.In this paper,we report a patient who underwent kidney re-transplantat...BACKGROUND There are few reported cases of allograft nephrectomy due to malignancy followed by successful renal re-transplantation two years later.In this paper,we report a patient who underwent kidney re-transplantation after living donor graft nephrectomy due to de novo chromophobe renal cell carcinoma(ChRCC)involving the allograft kidney.CASE SUMMARY A 34-year-old man underwent living kidney transplantation at the age of 22 years for end-stage renal disease.Maintenance immunosuppression consisted of tacrolimus,mycophenolate mofetil(MMF),and prednisone.Six years posttransplantation,at another hospital,ultrasonography revealed a small mass involving the upper pole of the graft.The patient declined further examination and treatment at this point.Seven years and three months post-transplantation,the patient experienced decreasing appetite,weight loss,gross hematuria,fatigue,and oliguria.Laboratory tests showed anemia(hemoglobin level was 53 g/L).Contrast-enhanced computed tomography revealed a large heterogeneous cysticsolid mass involving the upper pole of the renal allograft.Graft nephrectomy was performed and immunosuppressants were withdrawn.Histological and immunohistochemical features of the tumor were consistent with ChRCC.One year after allograft nephrectomy,low doses of tacrolimus and MMF were administered for preventing allosensitization.Two years after allograft nephrectomy,the patient underwent kidney re-transplantation.Graft function remained stable with no ChRCC recurrence in more than 2-years of follow-up.CONCLUSION De novo ChRCC in kidney graft generally has a good prognosis after graft nephrectomy and withdrawal of immunosuppression.Kidney re-transplantation could be a viable treatment.A 2-year malignancy-free period may be sufficient time before re-transplantation.展开更多
Representing 2%-3% of adult cancers, renal cell carcinoma(RCC) accounts for 90% of renal malignancies and is the most lethal neoplasm of the urologic system. Over the last 65 years, the incidence of RCC has increased ...Representing 2%-3% of adult cancers, renal cell carcinoma(RCC) accounts for 90% of renal malignancies and is the most lethal neoplasm of the urologic system. Over the last 65 years, the incidence of RCC has increased at a rate of 2% per year. The increased incidence is at least partly due to improved tumor detection secondary to greater availability of high-resolution cross-sectional imaging modalities over the last few decades. Most RCCs are asymptomatic at discovery and are detected as unexpected findings on imaging performed for unrelated clinical indications. The 2004 World Health Organization Classification of adult renal tumors stratifies RCC into several distinct histologic subtypes of which clear cell, papillary and chromophobe tumors account for 70%, 10%-15%, and 5%, respectively. Knowledge of the RCC subtype is important because the various subtypes are associated with different biologic behavior, prognosis and treatment options. Furthermore, the common RCC subtypes can often be discriminated non-invasively based on gross morphologic imaging appearances, signal intensity on T2-weighted magnetic resonance images, and the degree of tumor enhancement on dynamic contrast-enhanced computed tomography or magnetic resonance imaging examinations. In this article, we review the incidence and survival data, risk factors, clinical and biochemical findings, imaging findings, staging, differential diagnosis, management options and posttreatment follow-up of RCC, with attention focused on the common subtypes.展开更多
目的探讨CT平扫征象及CT动态增强在鉴别乏脂性血管平滑肌脂肪瘤(angiomy-olipoma with minimal fat,AMLmf)与三种常见病理类型肾癌的应用价值。方法选取83例肾脏实性肿块,其中15例经病理确诊为AMLmf,15例经病理确诊为肾脏乳头状细胞癌(P...目的探讨CT平扫征象及CT动态增强在鉴别乏脂性血管平滑肌脂肪瘤(angiomy-olipoma with minimal fat,AMLmf)与三种常见病理类型肾癌的应用价值。方法选取83例肾脏实性肿块,其中15例经病理确诊为AMLmf,15例经病理确诊为肾脏乳头状细胞癌(PRCC),27例经病理确诊为肾脏透明细胞癌(CCRCC),26例经病理确诊为肾脏嫌色细胞癌(ChRCC)。83例患者术前均行CT平扫及三期动态增强检查,分别测量肿块实性区域平扫及三期动态增强CT绝对值,随后计算平扫与增强各期之间CT绝对值,三组(乏脂性AML与乳头状细胞癌、乏脂性AML与透明细胞癌、乏脂性AML与嫌色细胞癌)病例各期CT绝对值比较行单因素方差分析;四类病例分别观察病灶平扫密度是否均匀、强化密度是否均匀、是否囊变、有无星芒状瘢痕、有无劈裂征、有无钙化,随后采用χ^(2)检验或Fisher确切概率法分析。结果AMLmf皮质期-平扫CT绝对值、排泄期-实质期CT绝对值均显著大于PRCC,实质期-皮质期CT绝对值显著小于PRCC,差异有统计学意义(P<0.05);AMLmf皮质期-平扫CT绝对值、实质期-皮质期CT绝对值、排泄期-实质期CT绝对值均显著小于CCRCC(P<0.05);AMLmf皮质期-平扫CT绝对值小于ChRCC,差异有统计学意义(P<0.05);AMLmf最大径显著小于PRCC、ChRCC,差异有统计学意义(P<0.05);在劈裂征方面,AMLmf与三种肾癌比较差异均有统计学意义(P<0.05);在强化是否均匀、有无囊变、肿瘤生长内生/外生方面,AMLmf与CCRCC比较差异有统计学意义(P<0.05),余差异无统计学意义。结论CT动态增强各期CT绝对值及CT征象有利于鉴别AMLmf及三种常见类型肾癌。展开更多
Chromophobe renal cell carcinoma （CRCC） is a distinctive, but not rare, malignant renal neoplasm.Series studies have revealed that the incidence of CRCC is between 3.6% and 10.4% of all kidney neoplasms. In China, t...Chromophobe renal cell carcinoma （CRCC） is a distinctive, but not rare, malignant renal neoplasm.Series studies have revealed that the incidence of CRCC is between 3.6% and 10.4% of all kidney neoplasms. In China, the first CRCC case was described by our hospital in 1998; there have since been only a few case reports of CRCC in China and very few instances of long-term follow-up. To our knowledge, there is little information available regarding the clinical outcomes of patients with CRCC. In order to analyze the clinical and pathologic characteristics of CRCC and the prognosis in Chinese patients, we reviewed retrospectively the clinical data from cases of CRCC treated recently in our hospital.展开更多
Background:Renal cell carcinoma(RCC)is among the top adult cancers worldwide,with a challenging management due to lack of early diagnosis,therapy resistance,and diverse molecular background.Aberrant DNA methylation ha...Background:Renal cell carcinoma(RCC)is among the top adult cancers worldwide,with a challenging management due to lack of early diagnosis,therapy resistance,and diverse molecular background.Aberrant DNA methylation has been associated with RCC development due to transcription deregulation.We discovered potential DNA methylation-based biomarkers for stage I RCC in Caucasian population from The Cancer Genome Atlas(TCGA)database.Methods:Patients’clinical,methylation beta-value,and mRNA expression data were retrieved.Differential methylation and expression analysis were conducted to obtain differentially methylated CpG-gene pairs.Inversely correlated CpG-gene pairs between their expression and methylation levels were selected using Pearson’s correlation test and then screened for any recorded somatic mutations.Their biomarker capacities were analyzed’using the Kaplan-Meier and receiver operating characteristic analysis,followed by protein network and functional enrichment analysis.Results:We obtained differentially methylated CpGs in clear cell(KIRC)and papillary RCC(KIRP)but not chromophobe RCC(KICH).Six inversely correlated CpG-gene pairs with no reported cancer-associated mutations were selected.Prognostic values were found in ATXN1 and RFTN1 for KIRC,along with GRAMD1B and TM4SF19 for KIRP,while diagnostic values were found in VIM and RFTN1 for KIRC,along with TNFAIP6 and TM4SF19 for KIRP.Both subtypes showed enrichment of immune and metabolism-related pathways.Conclusion:We discovered novel potential DNA methylation-based prognostic and diagnostic markers for early-stage RCC in Caucasian population.Validation by wet laboratory analysis and adjustments for confounding variables might be needed,considering our study limitation to specific race.展开更多
基金financially supported by National Natural Science Foundation of China(Nos.81372335,81402108)the China Postdoctoral Science Foundation(No.2014M551915)
文摘Background:Erythrocytosis,a rare paraneoplastic syndrome,generally occurs in patients with clear cell renal cell carcinoma and has never been reported in patients with chromophobe renal cell carcinoma.Case presentation:We report a case of a young man suffering from a giant(22-cm) mass on his left kidney.Because of a history of polycythemia vera,the patient had been treated for the condition for 9 years.Radical nephrectomy was successfully performed,and the postoperative pathologic examination confirmed a diagnosis of chromophobe renal cell carcinoma.Unexpectedly,the symptom of erythrocytosis disappeared after the surgery.Further examination and analysis were performed,and we finally attributed his erythrocytosis to chromophobe renal cell carcinoma.Conclusions:Chromophobe renal cell carcinoma could cause erythrocytosis,but the clear-cut mechanism needs further research.Secondary erythrocytosis such as those related with renal tumors should be taken into consideration during the diagnosis of polycythemia vera.
文摘Chromophobe renal cell carcinoma(ChRCC)is the third most common renal cell carcinoma(RCC)subtype,which predominantly occurs in sporadic setting.ChRCCs are considered to originate from the intercalated cell of distal tubules with two main morphological variants,classic and eosinophilic.Most ChRCCs carry a favorable clinical outcome.Histology alone is limited in predicting the behavior of ChRCCs that do not have overtly aggressive morphologic findings such as necrosis and sarcomatoid features.Along with positive CD117 expression,classic ChRCCs generally express diffuse and uniform CK7,while eosinophilic variant demonstrates more heterogeneous CK7 expression(rare or patchy).Multiple losses of chromosomes 1,2,6,10,13,17,and 21 are considered to be the genetic hallmarks of classic and eosinophilic ChRCCs,while chromosomal gains are known to be associated with sarcomatoid ChRCCs.TP53 and PTEN are the two most frequently mutated genes in ChRCCs.The major challenge in the differential diagnosis of ChRCCs includes considerations around the eosinophilic variant(of ChRCCs),where it may share overlapping features with oncocytoma or other recent emergent oncocytic tumors.Most eosinophilic ChRCCs share expression of the recently described biomarkers,LINC01187 and FOXI1,with classic ChRCCs,however,a subset of eosinophilic-like ChRCCs with lower biomarker expression have been demonstrated to harbor MTOR gene mutations.Overall,the morphologic features of ChRCCs and genetic profile with combinations of chromosomal losses and gains suggest this tumor entity to represent a distinct,yet heterogeneous group of renal neoplasms.
文摘BACKGROUND Renal cell carcinomas are usually unilateral.However,they are bilateral in 2%to 4%of sporadic cases and is considerably more common in familial cases.Synchronous sporadic bilateral multiple chromophobe renal cell carcinoma(CHRCC)with different subtypes is rare.CASE SUMMARY In this case report,we describe a case of synchronous bilateral CHRCC with two histological variants,accompanied by a clear cell carcinoma and a cyst in a 50-year-old male.The patient underwent retroperitoneal laparoscopic bilateral nephron-sparing surgery and there was no serious postoperative renal dysfunction.CONCLUSION We report a rare case of synchronous bilateral CHRCC with two histological variants associated with a clear cell carcinoma and a cyst.
文摘Synchronous bilateral multiple chromophobe cell renal carcinoma is rare; here we report a case diagnosed with bilateral renal multiple tumors complicated with a cyst in the right kidney. Retroperitoneal laparoscopic bilateral nephron sparing surgery was performed and there was no serious postoperative renal dysfunction. Pathological and immunohistochemical diagnoses of both tumors were chromophobe cell renal carcinoma. The patient has been doing well without any evidence of recurrence or metastasis for 6 months.
基金National Natural Science Foundation of,No.81970654.
文摘BACKGROUND There are few reported cases of allograft nephrectomy due to malignancy followed by successful renal re-transplantation two years later.In this paper,we report a patient who underwent kidney re-transplantation after living donor graft nephrectomy due to de novo chromophobe renal cell carcinoma(ChRCC)involving the allograft kidney.CASE SUMMARY A 34-year-old man underwent living kidney transplantation at the age of 22 years for end-stage renal disease.Maintenance immunosuppression consisted of tacrolimus,mycophenolate mofetil(MMF),and prednisone.Six years posttransplantation,at another hospital,ultrasonography revealed a small mass involving the upper pole of the graft.The patient declined further examination and treatment at this point.Seven years and three months post-transplantation,the patient experienced decreasing appetite,weight loss,gross hematuria,fatigue,and oliguria.Laboratory tests showed anemia(hemoglobin level was 53 g/L).Contrast-enhanced computed tomography revealed a large heterogeneous cysticsolid mass involving the upper pole of the renal allograft.Graft nephrectomy was performed and immunosuppressants were withdrawn.Histological and immunohistochemical features of the tumor were consistent with ChRCC.One year after allograft nephrectomy,low doses of tacrolimus and MMF were administered for preventing allosensitization.Two years after allograft nephrectomy,the patient underwent kidney re-transplantation.Graft function remained stable with no ChRCC recurrence in more than 2-years of follow-up.CONCLUSION De novo ChRCC in kidney graft generally has a good prognosis after graft nephrectomy and withdrawal of immunosuppression.Kidney re-transplantation could be a viable treatment.A 2-year malignancy-free period may be sufficient time before re-transplantation.
文摘Representing 2%-3% of adult cancers, renal cell carcinoma(RCC) accounts for 90% of renal malignancies and is the most lethal neoplasm of the urologic system. Over the last 65 years, the incidence of RCC has increased at a rate of 2% per year. The increased incidence is at least partly due to improved tumor detection secondary to greater availability of high-resolution cross-sectional imaging modalities over the last few decades. Most RCCs are asymptomatic at discovery and are detected as unexpected findings on imaging performed for unrelated clinical indications. The 2004 World Health Organization Classification of adult renal tumors stratifies RCC into several distinct histologic subtypes of which clear cell, papillary and chromophobe tumors account for 70%, 10%-15%, and 5%, respectively. Knowledge of the RCC subtype is important because the various subtypes are associated with different biologic behavior, prognosis and treatment options. Furthermore, the common RCC subtypes can often be discriminated non-invasively based on gross morphologic imaging appearances, signal intensity on T2-weighted magnetic resonance images, and the degree of tumor enhancement on dynamic contrast-enhanced computed tomography or magnetic resonance imaging examinations. In this article, we review the incidence and survival data, risk factors, clinical and biochemical findings, imaging findings, staging, differential diagnosis, management options and posttreatment follow-up of RCC, with attention focused on the common subtypes.
文摘目的探讨CT平扫征象及CT动态增强在鉴别乏脂性血管平滑肌脂肪瘤(angiomy-olipoma with minimal fat,AMLmf)与三种常见病理类型肾癌的应用价值。方法选取83例肾脏实性肿块,其中15例经病理确诊为AMLmf,15例经病理确诊为肾脏乳头状细胞癌(PRCC),27例经病理确诊为肾脏透明细胞癌(CCRCC),26例经病理确诊为肾脏嫌色细胞癌(ChRCC)。83例患者术前均行CT平扫及三期动态增强检查,分别测量肿块实性区域平扫及三期动态增强CT绝对值,随后计算平扫与增强各期之间CT绝对值,三组(乏脂性AML与乳头状细胞癌、乏脂性AML与透明细胞癌、乏脂性AML与嫌色细胞癌)病例各期CT绝对值比较行单因素方差分析;四类病例分别观察病灶平扫密度是否均匀、强化密度是否均匀、是否囊变、有无星芒状瘢痕、有无劈裂征、有无钙化,随后采用χ^(2)检验或Fisher确切概率法分析。结果AMLmf皮质期-平扫CT绝对值、排泄期-实质期CT绝对值均显著大于PRCC,实质期-皮质期CT绝对值显著小于PRCC,差异有统计学意义(P<0.05);AMLmf皮质期-平扫CT绝对值、实质期-皮质期CT绝对值、排泄期-实质期CT绝对值均显著小于CCRCC(P<0.05);AMLmf皮质期-平扫CT绝对值小于ChRCC,差异有统计学意义(P<0.05);AMLmf最大径显著小于PRCC、ChRCC,差异有统计学意义(P<0.05);在劈裂征方面,AMLmf与三种肾癌比较差异均有统计学意义(P<0.05);在强化是否均匀、有无囊变、肿瘤生长内生/外生方面,AMLmf与CCRCC比较差异有统计学意义(P<0.05),余差异无统计学意义。结论CT动态增强各期CT绝对值及CT征象有利于鉴别AMLmf及三种常见类型肾癌。
文摘Chromophobe renal cell carcinoma （CRCC） is a distinctive, but not rare, malignant renal neoplasm.Series studies have revealed that the incidence of CRCC is between 3.6% and 10.4% of all kidney neoplasms. In China, the first CRCC case was described by our hospital in 1998; there have since been only a few case reports of CRCC in China and very few instances of long-term follow-up. To our knowledge, there is little information available regarding the clinical outcomes of patients with CRCC. In order to analyze the clinical and pathologic characteristics of CRCC and the prognosis in Chinese patients, we reviewed retrospectively the clinical data from cases of CRCC treated recently in our hospital.
基金funded by an internal grant from Indonesia International Institute for Life Sciences(No.001/SK/WRH-IBSn/I/2020).
文摘Background:Renal cell carcinoma(RCC)is among the top adult cancers worldwide,with a challenging management due to lack of early diagnosis,therapy resistance,and diverse molecular background.Aberrant DNA methylation has been associated with RCC development due to transcription deregulation.We discovered potential DNA methylation-based biomarkers for stage I RCC in Caucasian population from The Cancer Genome Atlas(TCGA)database.Methods:Patients’clinical,methylation beta-value,and mRNA expression data were retrieved.Differential methylation and expression analysis were conducted to obtain differentially methylated CpG-gene pairs.Inversely correlated CpG-gene pairs between their expression and methylation levels were selected using Pearson’s correlation test and then screened for any recorded somatic mutations.Their biomarker capacities were analyzed’using the Kaplan-Meier and receiver operating characteristic analysis,followed by protein network and functional enrichment analysis.Results:We obtained differentially methylated CpGs in clear cell(KIRC)and papillary RCC(KIRP)but not chromophobe RCC(KICH).Six inversely correlated CpG-gene pairs with no reported cancer-associated mutations were selected.Prognostic values were found in ATXN1 and RFTN1 for KIRC,along with GRAMD1B and TM4SF19 for KIRP,while diagnostic values were found in VIM and RFTN1 for KIRC,along with TNFAIP6 and TM4SF19 for KIRP.Both subtypes showed enrichment of immune and metabolism-related pathways.Conclusion:We discovered novel potential DNA methylation-based prognostic and diagnostic markers for early-stage RCC in Caucasian population.Validation by wet laboratory analysis and adjustments for confounding variables might be needed,considering our study limitation to specific race.
