Is hypervascular papillary renal cell carcinoma present?
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KIDNEYS, URETERS, BLADDER, RETROPERITONEUM
Is hypervascular papillary renal cell carcinoma present? Tatsuya Yamamoto1 · Amori Gulanbar2 · Kuniyoshi Hayashi3 · Atsushi Kohno1 · Yoshinobu Komai4 · Junji Yonese4 · Kiyoshi Matsueda1 · Kentaro Inamura2 Received: 19 July 2020 / Revised: 21 September 2020 / Accepted: 30 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose We aimed to investigate atypical papillary renal cell carcinoma (PRCC) presenting with early contrast enhancement and late washout and to investigate the correlation between the CT attenuation value of the corticomedullary phase (CMP) of contrast-enhanced CT in PRCCs and the endothelial cell counts of these tumors. Methods Twenty-two patients with pathologically confirmed PRCC were enrolled in this study. PRCCs were categorized into 18 typical PRCCs and 4 atypical PRCCs. The CT attenuation value of the lesion in the CMP was measured in the maximal section of the tumor using the region of interest. Microvessel density (MVD) was evaluated as a histopathologic parameter using tissue specimens immunohistochemically stained with an anti-ERG antibody. The CT attenuation value and MVD were compared between atypical and typical PRCCs using the Mann–Whitney U test, where p < 0.05 was considered significant. The correlations between CT attenuation value and MVD were evaluated in all PRCCs using single linear regression analysis. Results The mean CT attenuation value and the MVD were significantly higher in atypical than in typical PRCCs. Correlation analyses revealed a weak positive correlation between the CT attenuation value and MVD. Conclusions We confirmed several cases of atypical PRCC that present with early contrast enhancement, such as clear cell renal cell carcinoma. In addition, a positive correlation was found between the CT attenuation value in the CMP of PRCCs and the vascular endothelial cell count. Keywords Papillary renal cell carcinoma · Computed tomography · Hypervascular tumor · Neovascularization Abbreviations CCRCC Clear cell renal cell carcinoma CMP Corticomedullary phase CT Computed tomography HU Hounsfield unit MVD Microvessel density PRCC Papillary renal cell carcinoma * Tatsuya Yamamoto [email protected] 1
Department of Diagnostic Radiology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3‑8‑31 Ariake, Koto‑ku, Tokyo 135‑8550, Japan
2
Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, 3‑8‑31 Ariake, Koto‑ku, Tokyo 135‑8550, Japan
3
Division of Biostatistics and Bioinformatics, Graduate School of Public Health, St. Luke’s International University, 3‑6‑2 Tsukiji, Chuo‑ku, Tokyo 104‑0045, Japan
4
Department of Urology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3‑8‑31 Ariake, Koto‑ku, Tokyo 135‑8550, Japan
RCC Renal cell carcinoma ROI Region of interest TDC Time density curve
Introduction Papillary renal cell carcinoma (PRCC) is the second most
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