Surgical Pathology Criteria

Mucinous Tubular and Spindle Cell Carcinoma of the Kidney

Differential Diagnosis

Mucinous Tubular and Spindle Cell Carcinoma of the Kidney Collecting Duct Carcinoma
Cytologically bland tubules Cytologically highly atypical tubules
Mucinous stroma Desmoplastic stroma
Circumscribed Aggressively invasive

Mucinous Tubular and Spindle Cell Carcinoma of the Kidney Papillary Renal Cell Carcinoma with Low Grade Spindle Cell Foci
Lacks areas of classic papillary carcinoma Areas of classic papillary carcinoma usually present
Mucinous stroma present Mucinous stroma generally absent
Lacks trisomy 7 and 17 Trisomy 7 and/or 17 present

Mucinous Tubular and Spindle Cell Carcinoma of the Kidney Metanephric Adenoma
Mucinous stroma Lacks mucinous stroma
CK7 pos CK7 neg

Mucinous Tubular and Spindle Cell Carcinoma of the Kidney Sarcomatoid Renal Cell Carcinoma
Lacks areas of classic renal cell carcinoma Aresa of classic renal cell carcinoma usually present
Cytologically bland spindle cells Cytologically atypical spindle cells
High grade sarcomatoid foci can arise in mucinous tubular and spindle cell carcinoma, but the uncomplicated MTSCC should not be considered sarcomatoid

Mucinous Tubular and Spindle Cell Carcinoma of the Kidney Renal Carcinoid
Mucinous stroma Lacks mucinous stroma
Lacks neuroendocrine chromatin pattern Stippled chromatin
Tubular and spindled growth patterns Trabecular growth pattern
Some cases of MTSCC have been reported to be positive for neuroendocrine markers

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