Publications by authors named "Levente Kuthi"

15 Publications

  • Page 1 of 1

Clear cell renal cell carcinoma with prominent microvascular hyperplasia: Morphologic, immunohistochemical and molecular-genetic analysis of 7 sporadic cases.

Ann Diagn Pathol 2022 Feb 25;56:151871. Epub 2021 Nov 25.

Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzen, Plzen, Czech Republic. Electronic address:

Clear cell renal cell carcinoma (CCRCC) is well known for intratumor heterogeneity. An accurate mapping of the tumor is crucial for assessing prognosis, and perhaps this can be linked to potential success/failure of targeted therapies. We assembled a cohort of 7 CCRCCs with prominent vasculature and microvascular hyperplasia (ccRCCPV), resembling those seen in high grade gliomas. A control group of classic CCRCC with no variant morphologies was also included. Both groups were analyzed for clinicopathologic, morphologic, immunohistochemical, and molecular genetic features. No statistically significant differences in mRNA expression of studied genes between the two groups were found. Using NGS panel Trusight Oncology 500 (TSO500), only one clinically significant gene mutation, VHL c.263G > A, p. (Trp88Ter), was found. TMB (Tumor Mutation Burden) and MSI (MicroSatellite Instability) were low, and no copy number variations (CNVs) were detected in the study cohort. Prominent microvascular hyperplasia in CCRCC is a rare phenomenon. From molecular genetic point of view, these tumors do not appear to be different from classic CCRCC. Prognostically, they also demonstrated similar clinical behaviors.
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http://dx.doi.org/10.1016/j.anndiagpath.2021.151871DOI Listing
February 2022

“Dum spiro spero”: clinicopathologic characteristics of SARS-CoV-2 infection

Orv Hetil 2021 11 7;162(45):1791-1802. Epub 2021 Nov 7.

1 Szegedi Tudományegyetem, Általános Orvostudományi Kar, Patológiai Intézet, Szeged, Állomás u. 1., 6725.

Összefoglaló. Bevezetés: A kórboncolás hozzájárul a súlyos akut légzőszervi szindrómát okozó koronavírus-2 (SARS-CoV-2-) fertőzés klinikopatológiai vonatkozásainak megismeréséhez. Célkitűzés: A SARS-CoV-2-fertőzöttek boncolása során gyűjtött tapasztalatok bemutatása. Módszer: Egymást követően boncolt, védőoltásban nem részesült, SARS-CoV-2-fertőzött elhunytak klinikai adatait, makro- és mikroszkópos észleleteit összegeztük; a tüdőkimetszéseket SARS-CoV-2-nukleokapszid-immunfestéssel vizsgáltuk. Eredmények: A boncolást a halálok megállapítására (n = 14), tumorgyanú (n = 9), illetve törvényi kötelezettség (n = 3) miatt végeztük. A fertőzést a klinikai észlelés vagy a boncolás során (n = 4) végzett SARS-CoV-2-nukleinsav-teszt igazolta. A tünetes betegség átlagos hossza 12,9 nap volt. 21 betegnél (medián életkor 69 év; 18 férfi) állt fenn COVID-19-pneumonia, mely 16 esetben önmagában, 4 esetben bakteriális pneumoniával vagy álhártyás colitisszel szövődve okozott halált; 1 antikoagulált pneumoniás beteg heveny retroperitonealis vérzésben halt meg. 3 betegnél a halált disszeminálódott malignus tumor, 1 betegnél coronariathrombosis, 1 mentálisan retardált betegnél pedig pulmonalis emboliás szövődmény okozta. A COVID-19-pneumoniás tüdők nehezek, tömöttek és vörösen foltozottak voltak. Szövettanilag a betegség időtartamától függően diffúz alveolaris károsodás korai exsudativ vagy későbbi proliferativ fázisa látszott atípusos pneumocytákkal; gyakori volt a microthrombosis (n = 7), a macrothrombosis (n = 5), illetve a pulmonalis embolia (n = 4). A SARS-CoV-2-immunfestés pozitívnak bizonyult az esetek 38,5%-ában, dominálóan az exsudativ fázisban. Minden elhunyt társbetegség(ek)ben szenvedett, így magasvérnyomás-betegségben (n = 17), érelmeszesedésben (n = 14), 2-es típusú diabetesben (n = 8), rosszindulatú daganatban (n = 6), krónikus obstruktív tüdőbetegségben (n = 4), elhízásban (n = 3), vesetranszplantáció utáni immunszuppresszióban (n = 3). Következtetés: Az irodalmi adatokkal összhangban, halálos COVID-19-pneumonia túlnyomóan idős, társbetegség(ek)től sújtott férfiakban alakult ki. A boncolási gyakorlatban a SARS-CoV-2-nukleokapszid-immunfestéstől a diffúz alveolaris károsodás korai fázisában várható pozitivitás. Orv Hetil. 2021; 162(45): 1791-1802.

Summary:

Introduction: Autopsy is an important tool for the evaluation of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Objectice: The aim of this study was to present our experience with autopsies of patients diagnosed with SARS-CoV-2 infection.

Method: Clinical data, macroscopic and microscopic findings of consecutive postmortems of non-vaccinated SARS-CoV-2 patients are summarized. Lung samples were evaluated with SARS-CoV-2 nucleocapsid immunohistochemistry.

Results: Autopsies were performed to determine the cause of death (n = 14), suspected tumours (n = 9) or due to legal obligation (n = 3). SARS-CoV-2 infection was verified by ante mortem (n = 22) and post mortem (n = 4) polymerase chain reaction. The mean duration of symptomatic disease was 12.9 days. Of 21 patients with COVID-19 pneumonia, 16 died of respiratory failure, 4 had additional bacterial pneumonia or Clostridioides difficile infection, and 1 developed hemorrhagic complication (n = 1). Other causes of death included disseminated malignancies (n = 3), coronary thrombosis (n = 1) and pulmonary embolism (n = 1). The affected lungs were heavy and had patchy red appearance. Exudative or proliferative phases of diffuse alveolar damage (DAD) were detected with atypical pneumocytes. Microthrombosis (n = 7), macrothrombosis (n = 5) and pulmonary embolism (n = 4) were frequent. The SARS-CoV-2 immunohistochemical reaction was positive in 38.5% of cases. All patients had co-morbidities, namely, hypertension (n = 17), atherosclerosis (n = 14), diabetes (n = 8), malignancies (n = 6), chronic obstructive pulmonary diseases (n = 4), obesity (n = 3) and immunosuppression after kidney transplantation (n = 3).

Conclusion: Fatal COVID-19 pneumonia occurred mostly in elderly males with co-morbidities. In the autopsy practice, the SARS-CoV-2 nucleocapsid immunohistochemical reaction may confirm the infectious etiology in the early phase of DAD. Orv Hetil. 2021; 162(45): 1791-1802.
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http://dx.doi.org/10.1556/650.2021.32387DOI Listing
November 2021

Multifocal Urinary Tract Metastasis of Colorectal Carcinoma.

Pathobiology 2022 15;89(1):56-62. Epub 2021 Sep 15.

Department of Pathology, University of Szeged, Szeged, Hungary.

Introduction: Secondary urinary tract tumors are uncommon findings and mainly evolve by direct invasion from adjacent organs. Actual metastatic involvement often develops in the urinary bladder, while the upper urinary tract is infrequently affected. In addition, the lungs, breast, and prostate gland are the usual primary sites. Colorectal carcinoma (CRC) may spread to the ureter directly or seeds via vascular or lymphatic channels. It may pose struggles in the differential diagnosis because CRC shares standard pathologic features with the primary adenocarcinoma of the urinary tract.

Case Presentation: We describe the case of an 81-year-old man who was referred to our hospital with a distal ureteral tumor that was treated by a ureteronephrectomy. The histopathological and genetic analysis established the diagnosis of metastatic CRC along with 3 metastases in the renal pelvis.

Conclusion: This rare case highlights the limitations of conventional histological processing, including immunohistochemistry, and it underlines the role of molecular investigations in certain circumstances.
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http://dx.doi.org/10.1159/000518967DOI Listing
September 2021

Eosinophilic vacuolated tumor (EVT) of kidney demonstrates sporadic TSC/MTOR mutations: next-generation sequencing multi-institutional study of 19 cases.

Mod Pathol 2021 Sep 14. Epub 2021 Sep 14.

Department of Pathology, University of Toronto, Toronto, ON, Canada.

A distinct renal tumor has recently been described as "high-grade oncocytic renal tumor" and "sporadic renal cell carcinoma with eosinophilic and vacuolated cytoplasm". The Genitourinary Pathology Society (GUPS) consensus proposed a unifying name "eosinophilic vacuolated tumor" (EVT) for this emerging entity. In this multi-institutional study, we evaluated 19 EVTs, particularly their molecular features and mutation profile, using next-generation sequencing. All cases were sporadic and none of the patients had a tuberous sclerosis complex. There were 8 men and 11 women, with a mean age of 47 years (median 50; range 15-72 years). Average tumor size was 4.3 cm (median 3.8 cm; range 1.5-11.5 cm). All patients with available follow-up data (18/19) were alive and without evidence of disease recurrence or progression during the follow-up, ranging from 12 to 198 months (mean 56.3, median 41.5 months). The tumors were well circumscribed, but lacked a well-formed capsule, had nested to solid growth, focal tubular architecture, and showed ubiquitous, large intracytoplasmic vacuoles, round to oval nuclei, and prominent nucleoli. Immunohistochemically, cathepsin K, CD117, CD10, and antimitochondrial antigen were expressed in all cases. Other positive stains included: PAX8, AE1/AE3 and CK18. CK7 was typically restricted only to rare scattered cells. Vimentin, HMB45, melan-A, and TFE3 were negative in all cases. All tumors showed retained SDHB. All cases (19/19) showed non-overlapping mutations of the mTOR pathway genes: TSC1 (4), TSC2 (7), and MTOR (8); one case with MTOR mutation showed a coexistent RICTOR missense mutation. Low mutational rates were found in all samples (ranged from 0 to 6 mutations/Mbp). Microsatellite instability and copy number variations were not found in any of the 17 analyzable cases. EVT represents an emerging renal entity that shows a characteristic and readily identifiable morphology, consistent immunohistochemical profile, indolent behavior, and mutations in either TSC1, TSC2, or MTOR genes.
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http://dx.doi.org/10.1038/s41379-021-00923-6DOI Listing
September 2021

Angiomyofibroblastoma in a male patient – a case report on a rare paratesticular lesion and review of the literature

Orv Hetil 2021 08 22;162(34):1376-1382. Epub 2021 Aug 22.

1 Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ, Radiológiai Klinika, Szeged, Semmelweis u. 6/A, 6725.

Összefoglaló. A scrotum képalkotó vizsgálóeljárásai közül elsőnek választandó az ultrahang, mivel könnyen hozzáférhető, szenzitivitása és specificitása magas. Szerepe kiemelendő mind az intratesticularis eltérések differenciáldiagnózisában, mind pedig a kevésbé ismert paratesticularis eltérések esetében. Az urológiai ambulancián egy 56 éves férfi jelentkezett kivizsgálásra tapintható terime miatt. Ultrahangvizsgálattal paratesticularis elváltozás látszódott, mely a vizsgálat során az inguinalis csatorna irányába többször elmozdult. A laesio dignitása nem volt meghatározható, ezért műtéti eltávolításra került sor. A szövettani vizsgálat a férfiak körében ritkán előforduló angiomyofibroblastoma diagnózisát véleményezte. A paratesticularis elváltozások ugyan ritkán fordulnak elő, de a gyakoribb entitások és azok ultrahangos sajátosságainak ismerete elengedhetetlen a terápia tervezése szempontjából. Orv Hetil. 2021; 162(34): 1376-1382. Summary. Ultrasonography is the basic imaging technique for the evaluation of testicular structures because it is easily accessible and has high sensitivity and specificity. It plays a significant role in the differential diagnosis of intratesticular changes, in addition, its role should be emphasised in rare paratesticular abnormalities. A 56-year-old male presented in the urology department complaining of a palpable inguinal mass and was referred to ultrasonography for further evaluation. A scrotal ultrasound was performed, and it described a mobile paratesticular mass without any specific characterizations. Therefore the lesion was removed, and the histological analysis established the diagnosis of angiomyofibroblastoma. Paratesticular lesions are rare, but it is essential to know the frequent abnormalities and the corresponding ultrasound findings for planning of treatment. Orv Hetil. 2021; 162(34): 1376-1382.
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http://dx.doi.org/10.1556/650.2021.32147DOI Listing
August 2021

Testicular adrenal rest tumor in the background of congenital adrenal hyperplasia

Orv Hetil 2020 04 1;161(16):623-631. Epub 2020 Apr 1.

Általános Orvostudományi Kar, Radiológiai Klinika,Szegedi TudományegyetemSzeged, Semmelweis u. 6/A, 6725.

The prevalence of testicular adrenal rest tumours varies in different forms of congenital adrenal hyperplasia. Patients with 21-hydroxilase deficiency usually have bilateral and palpable testicular nodules. Although adrenal rest tumours are well documented in the literature, the diagnosis and management require a multidisciplinary approach: the cooperative work of endocrinologists, urologists, pathologists and radiologists is essential. In the case of an early diagnosis, appropriately increased corticosteroid treatment may reduce the tumour mass. In advanced stages, tumours can lead to irreversible parenchymal damage causing infertility. The importance of an early and accurate diagnosis cannot be emphasized enough, since the therapy differs significantly from other benign or malignant testicular neoplasia. A case of a testicular adrenal rest tumour is presented along with the multidisciplinary perspectives of the diagnosis and management of these lesions. Orv Hetil. 2020; 161(16): 623–631.
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http://dx.doi.org/10.1556/650.2020.31696DOI Listing
April 2020

Inflammatory Myofibroblastic Tumors in the Uterus: Childhood-Case Report and Review of the Literature.

Front Pediatr 2020 14;8:36. Epub 2020 Feb 14.

University of Szeged, Szeged, Hungary.

Inflammatory myofibroblastic tumor (IMT) is a spindle cell neoplasm with low malignant potential, which may appear in different parts of the body. Uterine localization is rare, especially among children. Etiology is unclear, although some authors suggest underlying trauma or distress. A 3.5-year-old girl was treated at our institute for recurring vaginal bleeding without injury or known pathology. Physical examination and laboratory analysis revealed no specific findings, contrast-enhanced MRI found a 25 × 28 × 30 mm-sized inhomogeneous soft tissue mass in the uterus wall, which was excised in toto. Histological examination identified a spindle cell pattern, and the FISH test revealed ALK gene rearrangement, the lesion was defined as an IMT. Six cases were published to date, and their diagnostic methods are not equivocal, CT, and PET CT were preferred instead of MRI. Aggressive therapy seems to be exaggerated according to low recurrence and metastasis occurrence, and crizotinib is proved as good therapeutic agent in those cases. Biopsy and histology has important role in order to distinguish IMT from malignancies completed with FISH examination because ALK positivity strengthens the diagnosis. No lethal outcome was published among children, as our patient is also symptom-free after 3 years.
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http://dx.doi.org/10.3389/fped.2020.00036DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033747PMC
February 2020

Clinicopathological Findings on 28 Cases with XP11.2 Renal Cell Carcinoma.

Pathol Oncol Res 2020 Oct 18;26(4):2123-2133. Epub 2020 Jan 18.

Department of Pathology, University of Szeged, 1 Állomás Street, Szeged, H-6725, Hungary.

Xp11.2 translocation carcinoma is a distinct subtype of renal cell carcinoma characterized by translocations involving the TFE3 gene. Our study included the morphological, immunohistochemical and clinicopathological examination of 28 Xp11.2 RCCs. The immunophenotype has been assessed by using CA9, CK7, CD10, AMACR, MelanA, HMB45, Cathepsin K and TFE3 immunostainings. The diagnosis was confirmed by TFE3 break-apart FISH in 25 cases. The ages of 13 male and 15 female patients, without underlying renal disease or having undergone chemotherapy ranged from 8 to 72. The mean size of the tumors was 78.5 mm. Forty-three percent of patients were diagnosed in the pT3/pT4 stage with distant metastasis in 6 cases. Histological appearance was branching-papillary composed of clear cells with voluminous cytoplasm in 13 and variable in 15 cases, including one tumor with anaplastic carcinoma and another with rhabdoid morphology. Three tumors were labeled with CA9, while CK7 was negative in all cases. Diffuse CD10 reaction was observed in 17 tumors and diffuse AMACR positivity was described in 14 tumors. The expression of melanocytic markers and Cathepsin K were seen only in 7 and 6 cases, respectively. TFE3 immunohistochemistry displayed a positive reaction in 26/28 samples. TFE3 rearrangement was detected in all the analyzed cases (25/25), including one with the loss of the entire labeled break-point region. The follow-up time ranged from 2 to 300 months, with 7 cancer-related deaths. In summary, Xp11.2 carcinoma is an uncommon form of renal cell carcinoma with a variable histomorphology and rather aggressive clinical course.
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http://dx.doi.org/10.1007/s12253-019-00792-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7471254PMC
October 2020

[Provisional renal cell carcinoma subsets following the 2016 WHO classification].

Orv Hetil 2020 Jan;161(3):83-94

Patológiai Intézet, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Állomás u 1., 6725.

Renal cell carcinoma (RCC) represents a heterogenous group of malignant tumors that originate from the kidney parenchyma. The different entities have their own specific epidemiological, morphological, immunohistochemical, genetic and clinical characteristics. The new WHO classification of renal tumors was published in 2016, and it takes all of these features together into account. Although in the past three years, several emerging subtypes have been described, these are not yet included in the current classification. In this review paper, these entities are summarized in details including the following emerging subsets: thyroid-like follicular carcinoma, rearrangement-associated RCC, renal cell carcinoma with prominent smooth muscle stroma, fumarate hydratase-deficient RCC, biphasic squamoid papillary RCC, eosinophilic solid and cystic RCC, atrophic kidney-like RCC, clear cell RCC with giant cells and emperipolesis, Warthin-like papillary RCC, low-grade oncocytic renal tumor (CD117-negative; CK7-positive), high-grade oncocytic renal tumor, -mutated RCC and chromophobe RCC with neuroendocrine features. These entities are mostly diagnosed as RCC unclassified. The aim of this study is to introduce these subsets to the Hungarian pathologists, oncologists and urologists, to prompt diagnostic accuracy and to facilitate a collection along with a consecutive analysis of these cases. Orv Hetil. 2020; 161(3): 83-94.
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http://dx.doi.org/10.1556/650.2020.31654DOI Listing
January 2020

Giant Squamous Cell Papilloma of the Eyelid-Diagnostic and Therapeutic Challenges.

Case Rep Ophthalmol Med 2019 29;2019:5830493. Epub 2019 Oct 29.

Department of Ophthalmology, University of Szeged, Szeged, Hungary.

Squamous cell papilloma (SCP) is generally a human papillomavirus (HPV) induced exophytic or endophytic proliferation on the surface of the skin, oral cavity, larynx, esophagus, cervix, vagina, and anal canal. The endophytic type SCP can cause differential diagnostic difficulties with keratoacanthoma, inverted follicular keratosis, and squamous cell carcinoma; however, these lesions are not associated with HPV infection. The authors present a female patient who noticed an extremely rapidly growing tumor destructing the left lower eyelid. The histological analysis of the biopsy sample revealed a virus-induced squamoproliferative lesion. The eyelid affected was completely removed, and the histological examination resulted in a HPV induced endophytic squamous cell papilloma. The tarsus and the conjunctiva were replaced by a chondromucosal graft harvested from the nasal septum, while the skin defect could be closed directly. Restoration of the eyelid function has been achieved with satisfying functional and cosmetic results.
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http://dx.doi.org/10.1155/2019/5830493DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875255PMC
October 2019

Renal Cell Carcinoma with Clear Cell Papillary Features: Perspectives of a Differential Diagnosis.

Pathol Oncol Res 2020 Jul 26;26(3):1767-1776. Epub 2019 Oct 26.

Department of Pathology, University of Szeged, Szeged, Hungary.

Thirty-one cases of low-grade renal cell carcinoma (RCC) with clear cells and tubulopapillary/papillary architecture were analyzed retrospectively with immunohistochemical and genetic markers to gain more experience with the differential diagnosis of such cases. All samples coexpressed CK7 and CA9; the TFE3 or TFEB reactions were negative; the CD10 and the AMACR stainings were negative in 27 cases and 30 cases, respectively. The FISH assays for papillary RCC, available in 27 cases, and deletion of chromosome 3p, available in 29 cases, gave negative results. The results for 3p deletion, VHL gene mutation or VHL gene promoter region hypermethylation testing, along with the diffuse CD10-positivity in 2 cases confirmed 21 cases as clear cell papillary RCC (CCPRCC; CK7+, CA9+; no 3p loss, no VHL abnormality) and 10 cases as clear cell RCC (CCRCC; CK7+, CA9+; no 3p loss, VHL abnormality mutation/hypermethylation present). In CCPRCCs, the representative growth pattern was branching tubulo-acinar, commonly accompanied by cyst formation. The linear nuclear arrangement or cup-shaped staining of CA9 did not necessarily indicate CCPRCC, and the absence of these did not exclude the diagnosis of CCPPRC. One tumor infiltrated the renal sinus; the others exhibited pT1 stage; and metastatic outcome was not recorded. The CCRCC cases were in pT1 stage; 6 exhibited cup-shaped staining of CA9, and 1 displayed lymph node metastasis at the time of surgery. Distant metastatic disease was not observed. In summary, the VHL abnormalities distinguished the subset of CCRCC with diffuse CK7-positivity and no 3p loss from cases of CCPRCC.
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http://dx.doi.org/10.1007/s12253-019-00757-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297853PMC
July 2020

The Colorful Palette of Neuroendocrine Neoplasms in the Genitourinary Tract.

Anticancer Res 2018 Jun;38(6):3243-3254

Department of Oncotherapy, University of Szeged, Szeged, Hungary

Background: Neuroendocrine neoplasms include a heterogeneous group of malignant tumors. Primary neuroendocrine tumors in the genitourinary tract are rare, comprising approximately 1-2% of genitourinary malignancies.

Materials And Methods: An extensive search was performed for publications between 2000 and 2018 regarding neuroendocrine tumors of the genitourinary tract. Epidemiological, clinical, histopathological, prognostic and therapeutic data were evaluated.

Results: Neuroendocrine tumors of the kidneys are exceedingly rare, mostly well-differentiated. 0.5-1% of all primary bladder malignancies are small cell neuroendocrine carcinomas. Characteristically, prostatic adenocarcinoma with neuroendocrine differentiation occurs in androgen receptor-independent/castrate-resistant cancer. Small cell and large cell neuroendocrine carcinomas are the most aggressive tumors in each location.

Conclusion: Due to the rarity and poor prognosis of these tumors, proper pathological diagnosis and early therapy are important. Therapeutic guidelines are not available. Surgery, radiotherapy and/or chemotherapy are possible treatment options; somatostatin analogs are used as standard therapy in case of well-differentiated neuroendocrine tumors.
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http://dx.doi.org/10.21873/anticanres.12589DOI Listing
June 2018

Prognostic Factors for Renal Cell Carcinoma Subtypes Diagnosed According to the 2016 WHO Renal Tumor Classification: a Study Involving 928 Patients.

Pathol Oncol Res 2017 Jul 28;23(3):689-698. Epub 2016 Dec 28.

Department of Pathology, University of Szeged, Állomás Street 1, Szeged, H-6725, Hungary.

The morphotype and grade of renal cell carcinoma (RCC) in 928 nephrectomies were reclassified according to the 2016 WHO classification in order to analyze the distribution and outcomes of RCC subtypes in Hungary, to assess whether microscopic tumor necrosis is an independent prognostic factor in clear cell RCC, and to study whether a two-tiered grading (low/high) for clear cell and papillary RCC provides similar prognostic information to that of the four-tiered ISUP grading system. 83.4% of the cohort were clear cell, 6.9% papillary, 4.5% chromophobe, 2.3% unclassified, 1.1% Xp11 translocation, 1.1% clear cell papillary, 0.3% collecting duct and 0.1% mucinous tubular and spindle cell RCCs. RCC occurred in 16 patients with end-stage kidney disease and none of them displayed features of acquired cystic kidney disease-associated RCC. The 5-year survival rates were as follows: chromophobe 100%, clear cell papillary 100%, clear cell low-grade 96%, papillary type 1 92%, clear cell high-grade 63%, papillary type 2 65%, unclassified 46%, Xp11 translocation 20%, and collecting duct 0%. The 5-year survival rates in low-grade and high-grade papillary RCC were 95% and 59%, respectively. In clear cell RCC, only the grade, the stage and the positive surgical margin proved to be independent prognostic factors statistically. Overall, papillary RCC occurred relatively infrequently; microscopic tumor necrosis in clear cell RCC did not predict the outcome independently of the tumor grading; and the assignment of clear cell and papillary RCCs into low-grade or high-grade tumors was in terms of survival no worse than the ISUP grading.
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http://dx.doi.org/10.1007/s12253-016-0179-xDOI Listing
July 2017
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