title: Imprint cytologic features in renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion in an adult: a case report.
abstract: BACKGROUND
  Adult-onset renal cell carcinoma (RCC) associated with Xp11.2 translocation/TFE3 gene fusion is a very rare tumor. To date, there are no reports on immunocytochemical study of the primary tumor. We describe such a case that we diagnosed by immunocytochemistry of imprint cytology material.
  
  
  METHODS
  A 46-year-old man was found to have a mass in the lower pole of the right kidney. Magnetic resonance imaging (MRI) T2-weighted images showed a hypointense area in the tumor, and papillary RCC was suspected. Imprint cytology showed tumor cells that were isolated or arranged in large or small papillary clusters. Irregularly shaped large oval nuclei, finely granular chromatin and a single large nucleolus were noted. Cytoplasm was abundant and admixed with clear and granular eosinophilic patterns and scattered large vacuolated cells. Almost all tumor cells diffusely expressed immunocytochemical reactivity to TFE3 protein. Hyaline nodules were observed in the stroma. Ultrastructurally, neoplastic cells contained rhomboid crystals identical to those of alveolar soft part sarcoma.
  
  
  CONCLUSIONS
  The immunocytochemistry of TFE3 protein may be a powerful tool for accurate diagnosis when RCC associated with Xp11.2 translocation/TFE3 gene fusion is suspected by imprint cytology even in adult-onset cases, and cytotechnologists should accurately recognize cytologic findings of this tumor.
authors.affiliation: Department of Cytopathology, Ayabe City Hospital, Ayabe, Kyoto, Japan. yamaguchi.t@ayabe-hsp.or.jp
authors.forename: Tadanori
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Naoto
authors.initials: N
authors.lastname: Kuroda
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Imamura
authors.forename: Ondrej
authors.initials: O
authors.lastname: Hes
authors.forename: Takako
authors.initials: T
authors.lastname: Kawada
authors.forename: Keizou
authors.initials: K
authors.lastname: Nakayama
mesh_terms: D000328:Adult; D051778:Basic Helix-Loop-Helix Leucine Zipper Transcription Factors / Q000235:genetics*; D002292:Carcinoma, Renal Cell / Q000235:genetics* / Q000473:pathology* / Q000648:ultrastructure; D002449:Cell Aggregation; D041321:Chromosomes, Human, X / Q000235:genetics*; D003584:Cytological Techniques / Q000379:methods*; D050939:Gene Fusion; D006801:Humans; D007150:Immunohistochemistry; D007668:Kidney / Q000473:pathology; D007680:Kidney Neoplasms / Q000235:genetics* / Q000473:pathology / Q000648:ultrastructure; D008297:Male; D014178:Translocation, Genetic
chemical_list: D051778:Basic Helix-Loop-Helix Leucine Zipper Transcription Factors; C069203:TFE3 protein, human