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Papillary renal tumors. Morphologic, cytochemical, and genotypic features
D J Lager1, B J Huston, T G Timmerman
1University of Iowa, Department of Pathology, Iowa City, USA.
Cancer
|August 15, 1995
Summary
High-grade papillary renal tumors exhibit aggressive behavior and higher stage, unlike low-grade tumors. Trisomy of chromosome 7 aids in distinguishing papillary from nonpapillary renal neoplasms.
Area of Science:
- Oncology
- Genetics
- Uropathology
Background:
- Papillary renal tumors possess distinct genotypic features, including trisomy of chromosomes 7 and 17, differing from nonpapillary carcinomas.
- These tumors lack alterations of chromosome 3.
Purpose of the Study:
- To identify morphologic features distinguishing high-grade from low-grade papillary renal tumors.
- To assess the utility of trisomy of chromosome 7 in differentiating papillary from nonpapillary renal neoplasms.
Main Methods:
- Examination of 39 papillary renal neoplasms for morphologic features.
- Analysis of 29 papillary and 13 nonpapillary tumors for trisomy of chromosome 7 using fluorescence in situ hybridization.
- Recording of tumor size, stage, grade, architectural pattern, and presence of glycogen, foam cells, and iron.
Main Results:
- High-grade tumors (20) showed tall papillae, solid/tubular areas, and more intracellular glycogen compared to low-grade tumors (19).
- High-grade tumors were of higher stage, and metastases occurred exclusively in patients with high-grade tumors.
- Trisomy of chromosome 7 was present in 67% of low-grade, 43% of high-grade papillary tumors, and none of the nonpapillary tumors.
Conclusions:
- Papillary renal carcinomas with high nuclear grade are associated with aggressive behavior and poorer survival outcomes.
- Low-grade papillary renal tumors may correlate with longer disease-free survival.
- Trisomy of chromosome 7, detected by fluorescence in situ hybridization, is a valuable marker for differentiating papillary from nonpapillary renal neoplasms.