METHODS: Five cytology cases were gathered from 3 institutes.
RESULTS: Cohort consisted of 4 females and 1 male. Fine needle aspiration biopsy and touch preparation slides of core needle biopsy revealed cellular samples, composed of round, plasmacytoid, or columnar cells. Tumor cells were present in nested, acinar, 3D cluster, and individual cell patterns. Tumor cells in 3 cases exhibited uniformly round to oval small nuclei with inconspicuous nucleoli, finely granular chromatin, and smooth nuclear membranes, whereas 2 other cases showed pleomorphic nuclei with conspicuous nucleoli, nuclear molding, and irregular nuclear membranes. Tumor cells displayed pale or granular cytoplasm, with 1 case showing small vacuoles. Examination of cores and cell blocks demonstrated tumor cells in sheets, nests, or acini. All tumor cells were positive for neuroendocrine immunomarkers. Based on mitotic count, Ki-67 index and morphology, 3 tumors were graded as well-differentiated neuroendocrine tumor (WDNET) (1 grade [G] 3, 1 G2, 1 G1) and 2 as large cell neuroendocrine carcinoma. Deletion of 7q, 10q, and 19q was detected in WDNETs. Two patients with large cell neuroendocrine carcinoma and 1 with WDNET G3 underwent chemotherapy due to aggressiveness, whereas nephrectomy was performed for patients with WDNET G1 and 2 without metastasis.
CONCLUSIONS: Cytopathological characteristics of renal NENs closely resemble those affecting other organs. Despite its rarity, renal NENs should be kept in mind when confronted with morphological resemblances to NENs, to prevent misdiagnosis and inappropriate therapeutic interventions.
方法:从3个研究所收集5例细胞学病例。
结果:队列由4名女性和1名男性组成。细针穿刺活检和芯针穿刺活检的接触准备幻灯片显示细胞样本,由圆形组成,浆细胞样细胞,或柱状细胞。肿瘤细胞以巢状存在,腺泡,3D群集,和单个细胞模式。3例肿瘤细胞呈均匀圆形至卵圆形小核,核仁不明显。细颗粒状染色质,和光滑的核膜,而其他2例显示多形核,核仁明显,核成型,和不规则的核膜。肿瘤细胞显示苍白或颗粒状细胞质,1例显示小空泡。核心和细胞块的检查显示了薄片中的肿瘤细胞,巢,或者acini.所有肿瘤细胞的神经内分泌免疫标志物均为阳性。根据有丝分裂计数,Ki-67指数和形态学,3个肿瘤分级为高分化神经内分泌肿瘤(WDNET)(1级[G]3、1G2、1G1),2个为大细胞神经内分泌癌。删除7q,10q,在WDNETs中检测到19q。2例大细胞神经内分泌癌和1例WDNETG3患者因侵袭性而接受化疗,而对WDNETG1和2无转移的患者进行了肾切除术。
结论:肾NENs的细胞病理学特征与影响其他器官的细胞病理学特征非常相似。尽管它很罕见,当面对与NEN的形态相似时,应牢记肾NEN,防止误诊和不适当的治疗干预。