Kidney and Adrenal Gland

Renshaw, Andrew A.; Cibas, Edmund S.

doi:10.1016/b978-1-4557-4462-6.00015-5

Cited by 10 publications

(7 citation statements)

References 202 publications

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“…However, differentiating an adrenal cortical adenoma from a welldifferentiated adrenal cortical carcinoma could be very challenging when the findings are equivocal. 27 This creates a need for a uniform language in reporting such lesions.…”

Section: Discussionmentioning

confidence: 99%

“…At the opposite end of the spectrum, the presence of isolated cells with intact cytoplasm, marked nuclear atypia, frequent mitoses, and necrosis would point to a poorly differentiated adrenocortical carcinoma in a patient with an isolated adrenal tumor. However, differentiating an adrenal cortical adenoma from a well‐differentiated adrenal cortical carcinoma could be very challenging when the findings are equivocal 27 . This creates a need for a uniform language in reporting such lesions.…”

Section: Discussionmentioning

confidence: 99%

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Adrenal gland cytology reporting: a multi‐institutional proposal for a standardized reporting system

Trabzonlu

Jäger

Tabibi

et al. 2022

Cancer Cytopathology

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BACKGROUND:With the development of new technologies and the changing patient profiles, cytopathology departments receive increasing numbers of adrenal gland cytology specimens. In this study, the authors analyzed archival adrenal gland cytology cases and attempted to implement a diagnostic reporting system. DESIGN: Retrospective electronic medical record search was performed for adrenal gland cytology specimens in seven tertiary care centers. The cytology diagnoses were grouped in 7 categories: nondiagnostic, nonneoplastic, benign adrenal cortical elements (BACE), primary neoplasm of noncortical origin (NONC), atypia of undetermined significance (AUS), suspicious for malignancy (SM), and malignant (MAL). If available, histopathology results of concurrent and/or follow-up biopsies and/or resections were documented. RESULTS:A total of 473 adrenal gland cytology cases were included. BACE cases comprised 21.8%, whereas MAL cases were 57.5% of all cases. For BACE and MAL categories, there were 100% and 98.9% correlation, respectively, in the cases with histopathology follow-up. Six of 10 NONC cases had histopathology diagnoses and there were 3 pheochromocytomas and 3 schwannomas. Twenty-one AUS cases had histology follow-up and 10 (47.6%) of them were malignant. Six cases of SM had histopathology follow-up, and all of them were malignant on the follow-up. CONCLUSIONS: The authors propose a 7-tier diagnostic scheme for adrenal gland cytology. The risk of malignancy was 98.9% in MAL cases (87/88) in the cohort.The only case with discordance was reported as "adrenal cortical adenoma with marked atypia"' on resection. There was no difference between endoscopic ultrasound-guided and percutaneous methods. Further studies are needed to validate and make this approach universal.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adrenal gland cytology reporting: a multi‐institutional proposal for a standardized reporting system

Trabzonlu

Jäger

Tabibi

et al. 2022

Cancer Cytopathology

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“…For metastatic RCC or adrenal cortical carcinoma, the clinical history is helpful. RCC has more clear or vacuolated cytoplasm, and nucleoli are variable in size depending on the Fuhrman grade . There are more isolated cells with granular cytoplasm and moderate‐to‐marked atypia in adrenocortical carcinoma compared to ASPS.…”

Section: Discussionmentioning

confidence: 99%

Fine‐needle aspiration of alveolar soft part sarcoma: Histologic correlation and aberrant CD68 expression

Zhou

et al. 2018

Diagnostic Cytopathology

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Alveolar soft part sarcoma is a rare highly malignant neoplasm of the soft tissue and usually occurs in the lower extremities of children and young adults. We report two cases of alveolar soft part sarcoma: a 24-year-old Latino man with a 10-cm neck mass and a 56-year-old Latino woman with a recurring thigh mass. Fine-needle aspiration and a core biopsy were performed on both, which was followed by tumor resection on the man. The smears displayed numerous loosely cohesive or single large cells with abundant granular cytoplasm, round nuclei, vesicular chromatin, and occasional prominent nucleoli. Periodic and Schiff (PAS)-positive, diastaseresistant rhomboid, or needle-shaped crystals were present. Both tumors had diffuse and strong nuclear TFE3 expression and aberrant cytoplasmic CD68 expression. Fluorescence in situ hybridization analysis was performed in the first case, which detected a characteristic translocation t(X;17)(p11;q25). The diagnosis of alveolar soft part sarcoma was rendered in both cases.Herein, we present the cytology, histology, immunohistochemistry, and molecular findings and discuss the differential diagnosis. K E Y W O R D S aberrant CD 68 expression, alveolar soft part sarcoma, crystal, fine-needle aspiration, TFE3 expression 1 | INTRODUCTION Alveolar soft part sarcoma (ASPS) is a rare highly malignant neoplasm and accounts for 0.2%-0.9% of the soft tissue sarcoma. 1 A female predominance is seen in patients younger than 30 years. 2,3 ASPS usually arises from deep soft tissue of the thigh or buttock. It usually affects the head and neck region such as tongue or orbit in infants and children. 2 Primary ASPS of visceral organs has also been reported. 4 ASPS usually presents as a solitary, painless, slowly growing soft tissue mass. Rarely, it may have an aggressive course. 5 The local recurrence rate is 20%-30%. 6 The most common metastatic sites are the brain and the lung. Current metastases in the brain and lung occur in approximately 30% of the patients. Prognosis is poor with survival of 12-17 months. 7,8 Cytogenetic study of ASPS has shown the unbalanced translocation der(17)t(X;17)(p11;q25) producing the fusion of the N-terminal region of the alveolar soft part sarcoma locus (ASPL) gene on17q25 to the C-terminal of transcription factor E3 (TFE3) on Xp11. This results in two types of fusion transcripts (ASPL-TFE3 types 1 and 2), which lead to tumorigenesis by transcriptional deregulation. 9 The overexpressed fusion protein can be detected by immunohistochemistry (IHC) with anti-TFE3 antibody. 10,11 There is limited published literature regarding the cytological features of ASPS. Extremely rare cases with diffuse immunoreactivity for CD68 in ASPS have been reported. 12,13 2 | CASE REPORTS 2.1 | Clinical history Case 1: The patient was a 24-year-old Latino man with a history of intellectual disability due to cerebral palsy presented with a posterior neck mass for a year. The mass had been enlarging over a few months. Physical examination revealed a 10 cm well-circumscribed soft mass arising...

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“…Renal cysts are the most common benign renal lesion and need to be distinguished from cystic renal tumors including multilocular cystic renal neoplasms of low malignant potential. Fortunately, the vast majority of renal cysts are diagnosed by radiology because biopsy is unreliable with a sensitivity of approximately 10% for purely cystic renal cell carcinoma 1 . Oncocytoma, angiomyolipoma (AML), and papillary adenoma have been the most common solid benign renal tumors, and criteria for their diagnosis are well described.…”

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confidence: 99%

“…The second consideration for cytologists is what criteria to use to make these diagnoses. Fortunately, criteria have already described for AML, 6–9 papillary adenoma, 1 oncocytoma, 10,11 and CCPRCT 12–14 . AML has both characteristic cytologic and immunohistochemical findings that usually allow a definitive diagnosis to be rendered.…”

mentioning

confidence: 99%