KMID : 0357920110450040371
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Korean Journal of Pathology 2011 Volume.45 No. 4 p.371 ~ p.378
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Prognostic Significance and Nature of Rhabdoid Features in Renal Cell Carcinoma
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Choe Mi-Sun
Hwang Il-Seon Park Ji-Young Kim Sang-Pyo
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Abstract
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Background: Recent reports have indicated that renal cell carcinoma (RCC) with rhabdoid features follows an aggressive clinical course. We investigated the prognostic significance and nature of the rhabdoid component.
Methods: We retrospectively analyzed the incidence and clinicopathologic characteristics of RCC with rhabdoid features in 174 radical nephrectomy cases. The specimens were examined histologically and immunohistochemically.
Results: Twelve of the 174 RCC cases (6.9%) showed rhabdoid features. Histologically, all the tumors with rhabdoid features were of the clear cell type. The presence of rhabdoid features was significantly associated with higher Fuhrman¡¯s nuclear grade and higher pathologic tumor stage at presentation. Among the 12 patients who showed the rhabdoid component, nine (75%) developed metastasis and seven (58.3%) died of disease-related causes. The presence of rhabdoid features was independently associated with metastasis and disease-related mortality. The rhabdoid cells were positive for vimentin; variably positive for pan-cytokeratin, epithelial membrane antigen, and CD10; and negative for cytokeratin 7, smooth muscle actin, desmin, E-cadherin, and c-Kit. No case showed loss of integrase interactor-1; one was p53 positive, and five were insulin-like growth factor mRNA binding protein 3 positive. The Ki-67 labeling index was 1-25% (mean, 5.5%).
Conclusions: The rhabdoid component is an independent prognostic factor for metastasis of RCC; therefore, identification of this component is critical.
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KEYWORD
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Carcinoma, renal cell, Kidney, Rhabdoid tumor, Prognosis, Metastasis
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