A human adult Wilms' tumor. Histologic, ultrastructural, and cytogenetic analysis

High-resolution genomic profiling of an adult Wilms' tumor: evidence for a pathogenesis distinct from corresponding pediatric tumors

Wilms' tumor (WT), the most common kidney tumor among children, is characterized by a triphasic morphology consisting of blastemal, epithelial, and stromal components. Adult WT is a rare malignancy displaying similar histological features. We here present the first published high-resolution genomic analysis of a mixed-type adult WT. This revealed a more pronounced genetic complexity than usually observed in children with mixed-type WT. The majority of chromosomes displayed uniparental disomies, and microdeletions were present in genes with known importance for tumor formation (LRP1B, FHIT, and WWOX) or organogenesis (NEGR1 and ZFPM2), abnormalities not previously reported for pediatric WT. Our results indicate that adult WT is a biological entity distinct from the corresponding pediatric tumor type.

Mitochondrial disorders in renal tumors

As early as 1930, Warburg discovered that metabolic alterations were associated with carcinogenesis and that cancer cells fermented even in the presence of oxygen using glycolysis to fulfill their energy needs, though less efficiently than with respiration. The kidney requiring a very active energy production for its pumping functions has a high mitochondrial activity. Kidney tumors can exist either in relatively benign forms, as for example, in oncocytomas that are crowded with mitochondria or in very aggressive forms such as in clear cell renal carcinomas that exhibit strongly down-regulated mitochondrial activities. These carcinomas can produce metastases that are resistant to anti-mitotic drugs and current treatments only delay the fatal issue. In this review, the mitochondrial alterations observed in various forms of renal tumors will be discussed with the aim of understanding how the knowledge of mitochondrial impairment mechanisms could be helpful to develop new anti-cancer strategies.

Wilms' tumor in adults: aspiration cytology and cytogenetics

The fine-needle aspiration cytologic findings of Wilms' tumor occurring in a 20-yr-old female patient and a 35-yr-old male patient showing blastemal, spindled sarcomatous and rare epithelial components are reported. The male patient had the typical presentation of renal mass with metastasis to lung and pleura, whereas the female patient had an unusual presentation with the tumor originated from the subcapsular nephrogenic zone of the kidney, extending into the liver without invasion into the renal cortex. Cytogenetic analysis of this case identified: 90, XXXX, +2x3-4, -5, -15, -16, -17, -17, i (17)(q10) x2. This finding may represent a genetic change associated with Wilms' tumor of older pediatric and young adult patients. To the best of our knowledge, this case is the sixth case with cytogenetic study and the first case revealing isochromosome 17q of an adult Wilms' tumor.

Isochromosome 7q in adult Wilms' tumor

We describe cytogenetic and histologic findings in a Wilms' tumor resected from a 37-year-old man. The tumor karyotype was 45,X,-Y,i(7)(q10). These findings are notable because overrepresentation of chromosome 7 long arm material, i(7)(q10) in particular, has been described recently as a nonrandom event in pediatric Wilms' tumors. The present case suggests a shared genetic pathway in the initiation or progression of some pediatric and adult Wilms' tumors.

Carcinoid in a horseshoe kidney. Morphology, immunohistochemistry, and cytogenetics

Renal carcinoids are very rare neoplasms. We were able to culture and subsequently karyotype a carcinoid located in the isthmus of a horseshoe kidney, which revealed the following chromosomal pattern: 47,XX, + 13[8]/46,XX,t(13;14)(q31;q11.2)[5]/46,XX[2]. The DNA index was 1. Our results, compared with the sparse data from the literature, suggest that carcinoid of the kidney has no cytogenetic aberrations in common with carcinoids from other anatomical sites reported. On the other hand, numerical and structural aberrations of chromosome 13 seem to play a crucial role in the development of metanephric-derived renal tumors.

Cytogenetics and molecular genetics of Wilms' tumor of childhood

We describe the way in which application of cytogenetic and molecular genetic techniques to the study of Wilms' tumor (WT) of the kidney and the associated congenital disorders, such as sporadic aniridia and the Beckwith-Wiedemann syndrome, has led to identification of two regions on the short arm of chromosome 11 (11p13 and 11p15) involved in tumor development. In addition, evidence shows that genomic imprinting may be an important factor in transformation. Such investigations have led to cloning of a candidate WT gene (WT1) from 11p13. Linkage studies in familial studies suggest that an additional locus is involved. Analysis of the cytogenetic data available on this tumor suggests that this may be situated on 1p, 16q, or 17p.