Morphological and Immunohistochemical Characteristics of Surgically Removed Paediatric Renal Tumours in Latvia (1997-2010)
Introduction. Paediatric renal tumours represent 7% of all childhood malignancies. The variable appearances of the tumours and their rarity make them especially challenging group of lesions for the paediatric pathologist. In Latvia diagnostics and treatment of childhood malignancies is concentrated in Children's Clinical University Hospital. Microscopic evaluation of them is realised in Pathology office of this hospital.
Aim of the study is to analyze morphologic spectrum of children kidney tumours in Latvia and to characterise them from modern positions with wide range of immunohistochemical markers using morphological material of Pathology bureau of Children's Clinical University Hospital.
Materials and methods. We have analyzed surgically removed primary renal tumours in Children Clinical University Hospital from the year 1997 till 2010. Samples were fixed in 10% formalin fluid, imbedded in paraffin and haematoxylin-eosin stained slides were re-examined. Immunohistochemical re-investigation was made in 65.91% of cases. For differential diagnostic purposes were used antibodies for the detection of bcl-2, CD34, EMA, actin, desmin, vimentin, CKAE1/AE3, CK7, Ki67, LCA, WT1, CD99, NSE, chromogranin, synaptophyzin, S100, myoglobin, miogenin, MyoD1 (DakoCytomation) and INI1 protein (Santa Cruz Biotechnology).
Results. During the revised period there were diagnosed 44 renal tumours. Accordingly of morphological examination data neoplasms were divided: 1) nephroblastoma - 75%, 2) clear cell sarcoma - 2.27%, 3) rhabdoid tumour - 4.55%, 4) angiomyolipoma - 4.55%, 5) embrional rhabdomyosarcoma - 2.27%, 6) mesoblastic nephroma - 4.55%, 7) multicystic nephroma - 4.55%, 8) angiosarcoma - 2.27%. Immunohistochemical investigation specify the diagnosis in 4.55% of patients. In case of embryonal rhabdomyosarcoma we found that immunophenotype is more typical for cellular mesoblastic nephroma (infantile renal fibrosarcoma) but one neuroblastoma was misdiagnosed as nephroblastoma.
Conclusions. 1. The most common childhood renal tumours in Latvia like in the world is nephroblastoma. 2. In Latvia there are diagnosed such rare pediatric tumours as clear cell sarcoma and rhabdoid tumour; amount of first one is like in the world, but rhabdoid tumour was more common in Latvia then in the world. 3. No cases of renal cell carcinoma was diagnosed under age of 18 what differs from the data of the world. 4. The results of our investigations proved that immunohistochemical analytic schemes for blastemal type nephroblastoma and mesenchymal kidney tumours in our hospital should be extend but for the precise diagnosis of rhabdoid tumour of kidney would be recommended cooperation between laboratories of several countries for the detection of INI1 protein expression.
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