Ultrastructural characteristics of primary renal epithelial tumours with granular oncocytic cytoplasm

Sandra Trivunić Dajko; Jovo Bogdanović; Bojana  Andrejić Višnjić; Milan Popović; Ondrej  Hes

doi:10.2298/VSP170629003T

Sandra Trivunić Dajko University of Novi Sad, Faculty of Medicine, Department of Pathology, Novi Sad, Serbia
Jovo Bogdanović University of Novi Sad, Faculty of Medicine, Department of Surgery, Novi Sad, Serbia;
Bojana Andrejić Višnjić University of Novi Sad, Faculty of Medicine, Department of Histology and Embriology, Novi Sad, Serbia
Milan Popović University of Novi Sad, Faculty of Medicine, Department of Histology and Embriology, Novi Sad, Serbia
Ondrej Hes Charles University Hospital, Department of Pathology, Plzen, Czech Republic

DOI: https://doi.org/10.2298/VSP170629003T

Ključne reči: bubreg, neoplazme, mikroskopija, elektronska, dijagnoza, diferencijalna, mitohondrije, citoplazmatske granule

Sažetak

Apstrakt

Uvod/Cilj. Ultrastrukturnom analizom tumora uočene su mnoge zajedničke osobine nekih neoplazmi, ali i specifičnosti. Primarni tumori bubrega sa granuliranom–onkocitnom citoplazmom su veoma heterogena grupa po svom histološkom poreklu i biološkom ponašanju, što rezultuje razlikom u terapiji i prognozi bolesti, zbog čega je neohodna precizna morfološka dijagnostika. Cilj rada bio je određivanje ultrastrukturnih sličnosti i razlika između primarnih epitelnih tumora bubrega sa granuliranom-onkocitnom citoplazmom. Metode. Analizom arhivskog i rutinskog materijala arhive Departmana za patologiju, Fakultetske bolnice u Plzenu, Republika Češka i Centra za patologiju i histologiju, Kliničkog centra Vojvodine u Novom Sadu, pronađeno je 346 primarnih renalnih epitelnih tumora sa granuliranom-onkocitnom citoplazmom koji su razvrstani u 5 grupa: 1. renalni onkocitomi (RO) (234 tumora); 2. onkocitni papilarni karcinomi bubrega (O-PRCC) (12 tumora); 3. sporadični hibridni onkocitno/hromofobni tumori bubrega (HOCT) van Birt Hogg Dubé sindroma (BHD) (14 tumora); 4. hromofobni karcinomi bubrega (ChRCC) (21 tumor) i 5. granulirani karcinomi bubrega (RCC) [64 tumora + 1 clear cell RCC (CRCC) sa hijalinim globulama]. Vršena je ultrastrukturna analiza tumorskih ćelija, na subcelularnom nivou, elektronskim mikroskopom (Philips elektronski mikroskop TEM 208), Departmana za patologiju, Fakultetske bolnice u Plzenu, Republika Češka. Rezultati. U svim analiziranim primarnim epitelnim tumorima bubrega sa granuliranom-onkocitnom citoplazmom dominatne organele bile su mitohondrije. Specifične ultrastrukturne osobine za RO bile su okrugle mitohondrije sa lamelarnim kristama, za ChRCC brojne tipične, citoplazmatske mikrovezikule, veličine 100–700 nm i mitohondrije sa tubulovezikularnim, lamelarnim i cirkularnim kristama. Ultrastrukturna specifičnost za hibridne tumore bile su retke mikrovezikule i brojne mitohindrije, za O-PRCC mitohondrije sa lamelarnim kristama i male intracitoplazmatske vezikule veličine 100–200 nm, a za granulirane RCC pored mitohondrija i „glassy“ hijaline globule (GHG). Zaključak. Ultrastrukturna analiza ukazuje na mitohondrije, kao dominatnu organelu u analiziranim tumorima. Elektronskom mikroskopijom uočene su i specifičnosti, odnosno razlike u izgledu krista, prisustvu i veličini vezikula, kao i deponovanje pigmenta u i van citoplazme, te “glassy” hijalinih globula.

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Ultrastrukturne karakteristike primarnih epitelnih tumora bubrega sa granuliranom-onkocitnom citoplazmom

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