View source for Multilocular cystic renal neoplasm of low malignant potential

{{ Infobox diagnosis
| Name       = {{PAGENAME}}
| Image      = 
| Width      =
| Caption    = 
| Synonyms   = multilocular clear cell renal cell carcinoma, multilocular cystic renal cell carcinoma
| Micro      = thin septa with (polygonal) cells with a clear cytoplasm, fibrous capsule (surrounds tumour), +/-calcification
| Subtypes   =
| LMDDx      = [[cystic renal disease]] with macrophages in the septa, cystic [[clear cell renal cell carcinoma]], [[tubulocystic carcinoma]]
| Stains     =
| IHC        =
| EM         =
| Molecular  =
| IF         =
| Gross      = completely cystic - no solid components, well-circumscribed
| Grossing   =
| Staging    = [[kidney cancer staging]]
| Site       = [[kidney]] - see ''[[kidney tumours]]''
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms   =
| Prevalence = rare (case reports)
| Bloodwork  =
| Rads       =
| Endoscopy  =
| Prognosis  = very good
| Other      =
| ClinDDx    = other cystic renal tumours (e.g. cystic [[clear cell renal cell carcinoma]]), cystic renal disease
| Tx         =
}}
'''Multilocular cystic renal neoplasm of low malignant potential''' is a rare [[kidney tumour]].

It is also known as '''multilocular clear cell renal cell carcinoma''',<ref name=pmid23798872>{{Cite journal  | last1 = Chowdhury | first1 = AR. | last2 = Chakraborty | first2 = D. | last3 = Bhattacharya | first3 = P. | last4 = Dey | first4 = RK. | title = Multilocular cystic renal cell carcinoma a diagnostic dilemma: A case report in a 30-year-old woman. | journal = Urol Ann | volume = 5 | issue = 2 | pages = 119-21 | month = Apr | year = 2013 | doi = 10.4103/0974-7796.110012 | PMID = 23798872 }}</ref> '''multicystic renal cell neoplasm of low malignant potential'''<ref>{{Ref DDxSPGU|200}}</ref> and '''multilocular cystic renal cell carcinoma''' (abbreviated '''MCRCC''').

As the behaviour of the tumour is very good,<ref name=pmid23893851>{{Cite journal  | last1 = Montironi | first1 = R. | last2 = Mazzucchelli | first2 = R. | last3 = Scarpelli | first3 = M. | last4 = Lopez-Beltran | first4 = A. | last5 = Cheng | first5 = L. | title = Update on selected renal cell tumors with clear cell features. With emphasis on multilocular cystic clear cell renal cell carcinoma. | journal = Histol Histopathol | volume = 28 | issue = 12 | pages = 1555-66 | month = Dec | year = 2013 | doi =  | PMID = 23893851 }}</ref> ''carcinoma'' was replaced with ''neoplasm of low malignant potential''.


==General==
*No recurrences or metastasis in the literature.<ref name=Ref_WMSP292>{{Ref WMSP|292}}</ref>
*Case report rare.<ref name=pmid21366448>{{Cite journal  | last1 = Agarwal | first1 = S. | last2 = Agrawal | first2 = U. | last3 = Mohanty | first3 = NK. | last4 = Saxena | first4 = S. | title = Multilocular cystic renal cell carcinoma: a case report of a rare entity. | journal = Arch Pathol Lab Med | volume = 135 | issue = 3 | pages = 290-2 | month = Mar | year = 2011 | doi = 10.1043/2010-0243-LE.1 | PMID = 21366448 }}</ref>
*May represent a subtype of [[clear cell renal cell carcinoma]].<ref name=pmid20348877>{{Cite journal  | last1 = Halat | first1 = S. | last2 = Eble | first2 = JN. | last3 = Grignon | first3 = DJ. | last4 = Lopez-Beltran | first4 = A. | last5 = Montironi | first5 = R. | last6 = Tan | first6 = PH. | last7 = Wang | first7 = M. | last8 = Zhang | first8 = S. | last9 = MacLennan | first9 = GT. | title = Multilocular cystic renal cell carcinoma is a subtype of clear cell renal cell carcinoma. | journal = Mod Pathol | volume = 23 | issue = 7 | pages = 931-6 | month = Jul | year = 2010 | doi = 10.1038/modpathol.2010.78 | PMID = 20348877 }}</ref>

==Gross==
Features:<ref name=Ref_WMSP292>{{Ref WMSP|292}}</ref>
*Completely cystic with thin septa.
**No solid nodules - required for diagnosis.<ref name=pmid9503503/>
*Well circumscribed.

Note:
*This tumour, radiologically, can often be separated from other cystic tumours.<ref name=pmid21722289>{{Cite journal  | last1 = You | first1 = D. | last2 = Shim | first2 = M. | last3 = Jeong | first3 = IG. | last4 = Song | first4 = C. | last5 = Kim | first5 = JK. | last6 = Ro | first6 = JY. | last7 = Hong | first7 = JH. | last8 = Ahn | first8 = H. | last9 = Kim | first9 = CS. | title = Multilocular cystic renal cell carcinoma: clinicopathological features and preoperative prediction using multiphase computed tomography. | journal = BJU Int | volume =  | issue =  | pages =  | month = Jul | year = 2011 | doi = 10.1111/j.1464-410X.2011.10247.x | PMID = 21722289 }}</ref>

==Microscopic==
Features:<ref name=Ref_WMSP292>{{Ref WMSP|292}}</ref><ref name=pmid9503503>{{Cite journal  | last1 = Eble | first1 = JN. | last2 = Bonsib | first2 = SM. | title = Extensively cystic renal neoplasms: cystic nephroma, cystic partially differentiated nephroblastoma, multilocular cystic renal cell carcinoma, and cystic hamartoma of renal pelvis. | journal = Semin Diagn Pathol | volume = 15 | issue = 1 | pages = 2-20 | month = Feb | year = 1998 | doi =  | PMID = 9503503 }}</ref>
*Thin septa with (polygonal) cells with a clear cytoplasm - required.
*Fibrous capsule (surrounds tumour) - required.
*+/-Calcification (common).

DDx:
*[[Benign cortical cyst of the kidney|Renal (cortical) cyst lined by clear cells]] - do ''not'' have clear cells within the wall of the cyst.<ref>{{Ref DDxSPGU|197}}</ref>
*[[Cystic renal disease]] with macrophages in the septa.
*Cystic [[clear cell renal cell carcinoma]].
*[[Tubulocystic carcinoma]].
*[[Cystic hygroma]].

===Images===
www:
*[http://www.archivesofpathology.org/action/showFullPopup?id=i1543-2165-135-3-290b-f01&doi=10.1043%2F2010-0243-LE.1 MCRNLMP (archivesofpathology.org)].<ref name=pmid23798872/>
*[http://www.karger.com/Article/ShowPic/365201?image=000365201_f03.JPG MCRNLMP - low mag. (karger.com)].<ref name=pmid25171490/>
*[http://www.karger.com/Article/ShowPic/365201?image=000365201_f04.JPG MCRNLMP - high mag. (karger.com)].<ref name=pmid25171490>{{Cite journal  | last1 = Tantisattamo | first1 = E. | last2 = Elam | first2 = A. | last3 = Cobb | first3 = J. | last4 = Ellis | first4 = CL. | last5 = Bailey | first5 = JL. | title = No tumor-free waiting period after treatment of multilocular cystic renal cell carcinoma: a new case and review of the literature. | journal = Am J Nephrol | volume = 40 | issue = 2 | pages = 151-6 | month =  | year = 2014 | doi = 10.1159/000365201 | PMID = 25171490 }}</ref>

==IHC==
*EMA +ve.
*Keratins +ve.
*CD68 -ve.

Note:
*Immunoprofile overlaps with [[CCRCC]].<ref name=pmid22982885>{{Cite journal  | last1 = Williamson | first1 = SR. | last2 = Halat | first2 = S. | last3 = Eble | first3 = JN. | last4 = Grignon | first4 = DJ. | last5 = Lopez-Beltran | first5 = A. | last6 = Montironi | first6 = R. | last7 = Tan | first7 = PH. | last8 = Wang | first8 = M. | last9 = Zhang | first9 = S. | title = Multilocular cystic renal cell carcinoma: similarities and differences in immunoprofile compared with clear cell renal cell carcinoma. | journal = Am J Surg Pathol | volume = 36 | issue = 10 | pages = 1425-33 | month = Oct | year = 2012 | doi = 10.1097/PAS.0b013e31825b37f0 | PMID = 22982885 }}</ref>

==Sign out==
<pre>
Kidney Mass, Right, Partial Nephrectomy:
     - Multilocular cystic renal neoplasm of low malignant potential, see comment and microscopic.

Comment: 
This lesion is generally believed to have a benign behaviour.
</pre>

===Micro===
The cyst lining cells are clear and eosinophilic and without prominent nucleoli. Cyst lining cells do not infiltrate the cyst wall. Benign remnants of renal parenchyma are not evident throughout the cyst walls. This lesion is both within the kidney and perinephric fat.

==See also==
*[[Renal tumours]].

==References==
{{Reflist|2}}

[[Category:Diagnosis]]
[[Category:Kidney tumours]]