Carcinoma renal de células ductales. Estudio clínico, patológico e inmunohistoquímico de 10 casos.

Background: Ductal cell carcinoma is an uncommon subtype of aggressive renal neoplasia arising from the medullary collecting ducts, which have been described in different countries and ethnic groups. Very few series of this tumor have been reported, and most publications in the medical literature deal with single cases. Patients and method: We present the clinicopathological findings of 10 cases collected during the last decade. The patients were 6 males and 4 females that ranged in age from 34 to 65 years (mean: 51.3 years). Hematuria, hidronephrosis, lumbar pain, renal lithiasis and weight loss were the main clinical symptoms related to the renal tumors. Four patients died due to the neoplasia, and in three of them widespread metastases were found in the postmortem examination. Results: Histologically, all the tumors showed a high Fuhrman nuclear-grade and were composed of a varied pattern of tubular, tubulopapillary, microcystic and trabecular epithelial cells growing in a desmoplastic stroma with mixed inflammation. Additionally in three tumors, we observed secretory metaplasia with signet ring cells, sarcomatoid changes and hyaline globules respectively. The tumor cells exhibited typical and consistent immunohistochemical positive staining with antibodies for cytokeratin 7, cytokeratin AE1/AE3 and Ulex europaeus lectin. Conclusions: Histopathological features together with the immunohistochemical staining for cytokeratin 7 and Ulex europaeus are in our view, the most important findings for the identification of renal ductal carcinoma that is an entity not yet well recognized by some clinicians and pathologists. [ABSTRACT FROM AUTHOR]