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Renal cell carcinoma with TFE3 translocation and succinate dehydrogenase B mutation.

TFE3易位相关和琥珀酸脱氢酶B突变型的肾细胞癌

Calió A,Grignon DJ,Stohr BA,Williamson SR,Eble JN,Cheng L
阅读:1002 Modern PathologyMar 2017; 30 (3): 316 - 469:407-415 

Abstract

Translocation renal cell carcinoma and succinate dehydrogenase (SDH)-deficient renal cell carcinoma are now recognized as specific renal tumor types in the World Health Organization (WHO) classification. Both have limited immunohistochemical positivity for epithelial markers, and the spectrum of morphology continues to widen for both of these entities. We identified four renal cell carcinomas with positive TFE3 immunohistochemical staining and negative SDHB staining. The patients (2F, 2M) ranged in age from 19 to 65 years. All tumors were composed, at least in part, of eosinophilic cells. Cytoplasmic inclusions, prominent nucleoli, and mitotic figures were seen in three tumors. Psammoma bodies were also present in two tumors. Using immunohistochemistry, a broad spectrum of commonly used renal tumor markers yielded nonspecific, limited positivity, including uniformly positive reactions for PAX8 but negative results for cathepsin K and HMB45. Fluorescence in situ hybridization results showed the presence of TFE3 gene rearrangement in all four tumors, and molecular analysis revealed SDHB mutations in neoplastic cells of three tumors. In one case, the same SDHB mutation was confirmed in the adjacent non-neoplastic tissue. We report for the first time the presence of both TFE3 translocation and SDHB mutation in the same tumor.

摘要

TFE3易位肾细胞癌和琥珀酸脱氢酶(SDH)-缺陷性肾细胞癌在现在的世界卫生组织(WHO)肾肿瘤分类中是特殊类型。两者对于免疫组织化学上皮标记物阳性有限,并且这两种类型的形态学范围不断扩大。我们确诊了四例免疫组化标记TFE3染色阳性和SDHB染色阴性的肾细胞癌。患者(2女,2男)年龄19〜65岁。所有肿瘤至少部分由嗜酸性细胞组成。三例观察到胞质包涵体、突出的核仁和核分裂。 两例有沙砾体。免疫组织化学染色结果显示:广泛常用的肾脏肿瘤标志物表现为非特异性、局限的阳性,如PAX8均匀阳性反应、但组织蛋白酶K和HMB45阴性。荧光原位杂交结果显示:所有四例肿瘤均存在TFE3基因重排,分子分析揭示三例肿瘤细胞中有SDHB突变,有一例在相邻的非肿瘤组织中有相同的SDHB突变。我们首次报道同一肿瘤中TFE3易位和SDHB突变同时存在。

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