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[Renal cell carcinoma with a spindle-cell element--sarcomatous or sarcomatoid?]
A M Rudman1, B de Bruin, L J Duyvené de Wit
1Department Anatomiese Patologie, Universiteit van die Oranje-Vrystaat, Bloemfontein.
Summary
This study examines two renal cell carcinomas with spindle-cell elements. Findings suggest some cases may be carcinosarcomas, not sarcomatoid renal cell carcinoma, indicating mesenchymal differentiation.
Area of Science:
- Pathology
- Oncology
- Renal Cell Carcinoma Research
Background:
- Renal cell carcinoma (RCC) can exhibit spindle-cell morphology, previously termed sarcomatoid RCC.
- Ultrastructural features of sarcomatoid RCC include specific desmosomes, basal lamina, and intracytoplasmic lumina.
Observation:
- Light and electron microscopy were used to analyze two RCC cases with spindle-cell components.
- Detailed ultrastructural analysis was performed on the spindle-cell elements.
Findings:
- The observed ultrastructural features in these two cases indicated mesenchymal differentiation.
- This contrasts with the previously documented epithelial differentiation markers in sarcomatoid RCC.
Implications:
- The findings challenge the classification of some spindle-cell RCCs.
- It is proposed that certain spindle-cell RCCs might represent true carcinosarcomas rather than sarcomatoid variants.
- This distinction has potential implications for diagnosis and treatment strategies.