Classification
In 2014, PRCC was first acknowledged as a renal tumor subtype by the World Health Organization (WHO) considering its distinct genetic, molecular and histologic characteristics. It is further divided into type 1 and type 2 based on morphological features. Type 1 Papillary Renal Cell Carcinoma
Type 1 PRCC, also known as a renal tumor caused by a genetic predisposition of hereditary papillary renal cancer syndrome, compromises approximately 25% of all PRCCs. In the perspective of immunochemistry, it has a profile of strong CK7 and alpha-methyl acyl-CoA racemase (AMACR) expression at most focal CA-IX expression. Histologically, its epithelium is composed of relatively small-sized simple cuboidal cells lined in a single layer. These cells are well-characterized by basophilic cytoplasm. Due to its solid growth, an extremely compact papillary architecture is often observed. Other morphological characteristics include intracellular hemosiderin and foamy macrophages placed inside of papillary fibrovascular cores or psammoma bodies. In general, the nuclei of type 1 PRCC belong to grade 1-2 of the Fuhrman system. Type 2 Papillary renal cell carcinoma
Accounting for 25% of PRCCs, type 2 PRCC is the pathological subtype that is most commonly associated with hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome. When compared to type 1, it shows more variation in protein expression mostly by loss of CK7. In a gross examination, it shows papillae covered by large cells abundant in eosinophilic cytoplasm. Its large spherical nuclei on papillary cores are arranged in a pseudo-stratified manner. Unlike type 1 PRCC, foamy macrophages and psammoma bodies are less common in case of type 2.
However, treatment requires
more than giving the anthelmintic, the patient should also receive dietary supplements to improve their general level of health, in particular iron supplementation is very important. Iron is an important constituent of a multitude of enzyme systems involved in energy metabolism, DNA synthesis and
drug detoxification.An infection of N. americanus parasites can be treated by using benzimidazoles, albendazole, and mebendazole. A blood transfusion may be necessary in severe cases of anemia. Light infections are usually left untreated in areas where reinfection is common. Iron supplements and a diet high in protein will speed the recovery process. In a case study involving 56–60 men with Trichuris trichiura and/or N. americanus infections, both albendazole and mebendazole were 90% effective in curing T. trichiura. However, albendazole had a 95% cure rate for N. americanus, while mebendazole only had a 21% cure rate. This suggests albendazole is most effective for treating both T. trichiura and N. americanus.During the 1910s, common treatments for hookworm included thymol, 2-naphthol, chloroform, gasoline, and eucalyptus oil. By the 1940s, the treatment of choice was tetrachloroethylene, given as 3 to 4 cc in the fasting state, followed by 30 to 45 g of sodium sulfate. Tetrachloroethylene was reported to have a cure rate of 80 percent for Necator infections, but 25 percent in Ancylostoma infections, requiring re-treatment. Epidemiology
Hookworm anaemia was first described by Wilhelm Griesenger in Egypt, Cairo in 1852.