Micropapillary pattern in a case of multilocular cystic renal neoplasm of low malignant potential

A. Bhat, M. Pai, N. Marla, M. Shetty, Joyce Jesudas
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Abstract

Multilocular cystic renal neoplasm of low malignant potential, formerly known as multilocular cystic renal cell carcinoma, is a relatively uncommon renal neoplasm. The peculiarity of this neoplasm lies in the absence of expansile solid nodules. We report a case of this uncommon neoplasm with a focal micropapillary pattern, which is a very rare feature. To the best of our knowledge, there are no case reports emphasizing on the micropapillary pattern in case of multilocular cystic renal neoplasm of low malignant potential. We report a case of a 57-year-old female patient who presented with pain abdomen. Ultrasound and computerized tomography of abdomen revealed a multilocular cystic renal mass. The patient underwent right nephrectomy and the specimen was sent for histopathological examination. Grossly, the enlarged lower pole on cutting open showed multiloculated fluid-filled cyst with smooth inner walls. Microscopically, the tumor was composed of cysts lined by cells with clear cytoplasm and of Fuhrman nuclear Grade 1. A rare feature seen was the disposition of tumor cells in micropapillary pattern. The case was reported as multilocular cystic renal neoplasm of low malignant potential. This neoplasm needs special consideration due to its good prognosis and potential amenability to cure by nephron-sparing surgery. Also to be noted is that a multilocular cystic renal neoplasm of low malignant potential can have a micropapillary pattern too.
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低恶性潜能多室囊性肾肿瘤微乳头状征象1例
低恶性潜能的多房囊性肾肿瘤,以前称为多房囊性肾细胞癌,是一种相对少见的肾脏肿瘤。这种肿瘤的特点在于没有可扩张的实性结节。我们报告一个罕见的肿瘤灶状微乳头状模式,这是一个非常罕见的特征。据我们所知,目前还没有病例报告强调低恶性潜能的多房囊性肾肿瘤的微乳头状征象。我们报告一例57岁的女性患者谁提出腹痛。腹部超音波及电脑断层显示多房囊性肾肿块。患者行右肾切除术,标本送组织病理检查。大体上,切开肿大的下极显示多室充满液体的囊肿,内壁光滑。显微镜下,肿瘤由细胞质清晰的细胞排列的囊肿组成,为Fuhrman核1级。罕见的特征是肿瘤细胞呈微乳头状分布。本病例报告为低恶性潜能的多房囊性肾肿瘤。由于其预后良好,且有可能通过保留肾单元的手术治愈,这种肿瘤需要特别考虑。同样值得注意的是,低恶性潜能的多室囊性肾肿瘤也可以有微乳头状形态。
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