Renal cell carcinoma pathology

Renal cell carcinoma pathology akuphatikizira kuunika kwapang'onopang'ono ndikuwunika minofu ya impso kuti azindikire ndikuyika khansa ya impso. Ndi gawo lofunikira kwambiri pozindikira mtundu, giredi, ndi gawo la khansayo, yomwe imadziwitsa zosankha zamankhwala ndikulosera zam'tsogolo. Kumvetsetsa mawonekedwe a pathological ndikofunikira kwa odwala komanso akatswiri azachipatala. Bukuli likupereka tsatanetsatane wa Renal cell carcinoma pathology, kuphatikizapo ma subtypes wamba, kachitidwe ka grading, staging, ndi udindo wa immunohistochemistry.Kumvetsetsa Renal Cell Carcinoma (RCC)Renal cell carcinoma (RCC) ndi mtundu wofala kwambiri wa khansa ya impso mwa akulu, pafupifupi 90% ya matenda onse a impso. Izi zimachokera ku minyewa ya proximal convoluted tubule, yomwe ndi timachubu ting'onoting'ono mu impso zomwe zimasefa magazi ndikutulutsa mkodzo. Kuzindikira kolondola ndi kugawa kwa RCC ndizofunikira kwambiri pakuwongolera njira zochiritsira zogwira mtima komanso kulosera zotsatira za odwala.Common Subtypes of Renal Cell CarcinomaMagawo angapo a RCC alipo, aliyense ali ndi mawonekedwe odziwika bwino a matenda, mawonekedwe a chibadwa, ndi machitidwe azachipatala. Ma subtypes awa amatha kusiyanitsidwa poyang'aniridwa ndi ma microscopic ndipo amatsimikiziridwa ndi immunohistochemistry. Magulu ang'onoang'ono akuphatikizapo: Clear Cell Renal Cell Carcinoma (ccRCC) Clear cell RCC ndiyo yomwe imapezeka kwambiri, yomwe imakhala pafupifupi 70-80% ya milandu yonse ya RCC. Amadziwika ndi ma cell omwe ali ndi cytoplasm yowoneka bwino kapena yotuwa chifukwa cha kuchuluka kwa glycogen ndi lipid. Maselo amenewa nthawi zambiri amapanga zisa kapena mapepala, ndipo chotupacho chimakhala ndi mitsempha yambiri. Amadziwika ndi mapangidwe a papillary, kutanthauza kuti maselo a chotupa amakula mofanana ndi chala. Pali mitundu iwiri ikuluikulu ya pRCC: Mtundu wa 1 ndi Mtundu wa 2. Mtundu wa 1 pRCC nthawi zambiri umakhala ndi chidziwitso chabwino kuposa Mtundu wa 2.Chromophobe Renal Cell Carcinoma (chRCC)Chromophobe RCC imayimira pafupifupi 5% ya milandu ya RCC. Maselo a chRCC ali ndi cytoplasm yotuwa ya eosinophilic ndi perinuclear halo yosiyana. Ma nuclei nthawi zambiri amakhala makwinya kapena osakhazikika.Collecting Duct Renal Cell Carcinoma (CDRCC) Collecting duct RCC ndi kagawo kakang'ono kosowa komanso koopsa komwe kamachokera ku njira zosonkhanitsira impso. Imawerengera zosakwana 1% ya milandu ya RCC. The chotupa maselo kupanga osakhazikika tubules ndi papillae, nthawi zambiri ndi desmoplastic stroma.Medullary aimpso Cell CarcinomaMedullary aimpso cell carcinoma ndi ena osowa ndi aukali subtype, makamaka zimakhudza achinyamata odwala ndi chikwakwa selo kapena chikwakwa. Kusiyanasiyana kumeneku kumadziwika ndi kansa yosiyanitsidwa bwino yokhala ndi chotupa chodziwika bwino cholowera.Kusankha kwa Renal Cell Carcinoma: The Fuhrman Grading System ndi ISUP Grading SystemKujambula kwa RCC kumawonetsa kuopsa kwa chotupacho potengera mawonekedwe a maselo pansi pa maikulosikopu. Dongosolo la grading la Fuhrman linkagwiritsidwa ntchito kale, koma dongosolo la International Society of Urological Pathology (ISUP) tsopano likuvomerezedwa kwambiri. The ISUP grading system imawona kutchuka kwa nucleolar ndi kusakhazikika kwa nyukiliya. Magulu apamwamba amawonetsa zotupa zowopsa kwambiri ndipo zimagwirizanitsidwa ndi kusauka bwino. Makhalidwe a ISUP Giredi 1 Ang'onoang'ono, nyukiliya yunifolomu yokhala ndi nucleoli yosadziwika kapena yosowa. Gulu 2 Miyendo yokulirapo pang'ono yokhala ndi ma nucleoli owoneka. Kalasi 3 Mizu yayikulu, yosakhazikika yokhala ndi ma nucleoli odziwika. Kalasi 4 Zosakhazikika bwino, minyewa ya pleomorphic yokhala ndi mawonekedwe odabwitsa kapena masiyanidwe a sarcoma. Staging of Renal Cell Carcinoma: The TNM SystemStaging ya RCC imalongosola kukula kwa khansayo, kuphatikizapo kukula kwa chotupa chachikulu (T), kukhudzidwa kwa ma lymph nodes (N), ndi kukhalapo kwa metastasis yakutali (M). Njira ya TNM ndiyo njira yomwe imagwiritsidwa ntchito kwambiri popanga ma RCC. Njira zolondola zamagulu a T, N, ndi M ndizovuta komanso zatsatanetsatane, zomwe zimaphatikizapo kukula kwa chotupa, kuwukira kwa ziwalo zozungulira, komanso kupezeka kwa metastasis ku ma lymph nodes kapena ziwalo zakutali. Akatswiri a zachipatala amagwiritsa ntchito zofukufuku zazing'ono kwambiri ndi zotsatira zojambula kuti apereke gawo loyenera la TNM. Immunohistochemistry mu Renal Cell Carcinoma PathologyImmunohistochemistry (IHC) ndi chida chofunikira kwambiri Renal cell carcinoma pathology. Zimaphatikizapo kugwiritsa ntchito ma antibodies kuti azindikire mapuloteni enieni mu zitsanzo za minofu. Njirayi imathandizira kusiyanitsa pakati pa ma RCC subtypes, kutsimikizira matenda, ndikuzindikira zomwe zingathandize. Zolemba zodziwika bwino za IHC zomwe zimagwiritsidwa ntchito mu RCC ndi izi: PAX8: Chizindikiro chomwe chimawonetsedwa kwambiri mu renal cell carcinomas, makamaka cell clear and papillary subtypes. CAIX: Amawonetsedwa pafupipafupi mu cell renal cell carcinomas. CK7: Yothandiza kusiyanitsa mitundu yaing'ono ya RCC, yomwe nthawi zambiri imakhala yabwino mu papillary ndi chromophobe RCC. Vimentin: Nthawi zambiri amakhala ndi sarcomatoid RCC. CD117 (c-KIT): Itha kukhala yothandiza pozindikira chromophobe RCC.Pathology Report: Key ElementsLipoti la matenda ndi chikalata chofunikira kwambiri chomwe chimafotokoza mwachidule zomwe zapezedwa pakuwunika kwa matenda. Mulinso zinthu zofunika izi: Zambiri za odwala ndi zitsanzo. Kufotokozera kwathunthu kwa chotupacho. Kufotokozera kwa Microscopic kwa maselo otupa ndi kamangidwe kake. RCC subtype matenda. Mtengo wa ISUP. Gawo la TNM. Zotsatira za Immunohistochemical staining. M'mphepete (ngati maselo a khansa alipo m'mphepete mwa minofu yochotsedwa). Ndemanga ndi chidule cha Pathologist.Udindo wa Shandong Baofa Cancer Research Institute mu Cancer ResearchMabungwe ngati Shandong Baofa Cancer Research Institute amatenga gawo lofunikira pakupititsa patsogolo kumvetsetsa kwathu ndi chithandizo cha khansa, kuphatikiza renal cell carcinoma. Pochita kafukufuku ndi mayesero a zachipatala, mabungwewa amathandizira pakupanga zida zatsopano zowunikira ndi mankhwala, potsirizira pake kupititsa patsogolo zotsatira za odwala.Renal cell carcinoma pathology ndi gawo lovuta kwambiri lomwe limaphatikizapo kufufuza mosamala ndi kusanthula minofu ya impso. Kumvetsetsa ma subtypes osiyanasiyana, kachitidwe ka grading, masanjidwe, ndi gawo la immunohistochemistry ndikofunikira pakuzindikiritsa kolondola, kuneneratu, komanso kukonza chithandizo. Kugwirizana pakati pa akatswiri azachipatala, oncologists, ndi akatswiri ena azachipatala ndikofunikira kwambiri popereka chisamaliro chabwino kwambiri kwa odwala omwe ali ndi RCC.Chodzikanira: Izi ndi za chidziwitso chambiri komanso zolinga zazambiri zokha, ndipo sizikupanga upangiri wamankhwala. Ndikofunikira kukaonana ndi dokotala wodziwa bwino za thanzi lanu kapena musanapange zisankho zokhudzana ndi thanzi lanu kapena chithandizo chanu.Zolozera: American Cancer Society National Kidney Foundation