Clear cell renal cell carcinoma - Revision history

Michael: /* IHC */

2026-09-01T20:23:02Z

IHC

← Older revision		Revision as of 20:23, 1 September 2026
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	==IHC==		==IHC==
			*CAIX (also CA9) +ve (47/59 cases ~ 94%).<ref name=pmid36340463>{{cite journal \|authors=Yousef A, Kim SS, Krizova A \|title=CAIX Immunostaining in Non-neoplastic Renal Diseases \|journal=Cancer Diagn Progn \|volume=2 \|issue=6 \|pages=661–667 \|date=2022 \|pmid=36340463 \|pmc=9628162 \|doi=10.21873/cdp.10157 \|url=}}</ref>
	*CD10 +ve.		*CD10 +ve.
	*Vimentin +ve.		*Vimentin +ve.
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	*Glut-1 >85% of CCRCC (membranous pattern).<ref name=pmid17638658>{{Cite journal \| last1 = Ozcan \| first1 = A. \| last2 = Shen \| first2 = SS. \| last3 = Zhai \| first3 = QJ. \| last4 = Truong \| first4 = LD. \| title = Expression of GLUT1 in primary renal tumors: morphologic and biologic implications. \| journal = Am J Clin Pathol \| volume = 128 \| issue = 2 \| pages = 245-54 \| month = Aug \| year = 2007 \| doi = 10.1309/HV6NJVRQKK4QHM9F \| PMID = 17638658 }}</ref>		*Glut-1 >85% of CCRCC (membranous pattern).<ref name=pmid17638658>{{Cite journal \| last1 = Ozcan \| first1 = A. \| last2 = Shen \| first2 = SS. \| last3 = Zhai \| first3 = QJ. \| last4 = Truong \| first4 = LD. \| title = Expression of GLUT1 in primary renal tumors: morphologic and biologic implications. \| journal = Am J Clin Pathol \| volume = 128 \| issue = 2 \| pages = 245-54 \| month = Aug \| year = 2007 \| doi = 10.1309/HV6NJVRQKK4QHM9F \| PMID = 17638658 }}</ref>
	*E-cadherin +ve - usually weak, often -ve in higher stage tumours.<ref name=pmid23939157>{{Cite journal \| last1 = Hu \| first1 = H. \| last2 = Chen \| first2 = JW. \| last3 = Xu \| first3 = KX. \| last4 = Wang \| first4 = D. \| last5 = Wang \| first5 = Y. \| last6 = Wang \| first6 = GW. \| last7 = Zhang \| first7 = SY. \| last8 = Wang \| first8 = XF. \| title = [Expressions of CMTM8 and E-cadherin in primary and metastatic clear cell renal cell carcinoma]. \| journal = Beijing Da Xue Xue Bao \| volume = 45 \| issue = 4 \| pages = 537-41 \| month = Aug \| year = 2013 \| doi = \| PMID = 23939157 }}</ref>		*E-cadherin +ve - usually weak, often -ve in higher stage tumours.<ref name=pmid23939157>{{Cite journal \| last1 = Hu \| first1 = H. \| last2 = Chen \| first2 = JW. \| last3 = Xu \| first3 = KX. \| last4 = Wang \| first4 = D. \| last5 = Wang \| first5 = Y. \| last6 = Wang \| first6 = GW. \| last7 = Zhang \| first7 = SY. \| last8 = Wang \| first8 = XF. \| title = [Expressions of CMTM8 and E-cadherin in primary and metastatic clear cell renal cell carcinoma]. \| journal = Beijing Da Xue Xue Bao \| volume = 45 \| issue = 4 \| pages = 537-41 \| month = Aug \| year = 2013 \| doi = \| PMID = 23939157 }}</ref>
	*CAIX (also CA9) +ve.

	A panel to confirm the diagnosis:		A panel to confirm the diagnosis:
	*CK7 (-ve), CD10 (+ve), PAX8 (+ve), vimentin (+ve).		*CAIX (+ve), CK7 (-ve), CD10 (+ve), PAX8 (+ve), vimentin (+ve).

	===CCRCC versus [[chromophobe RCC]]===		===CCRCC versus [[chromophobe RCC]]===

Michael: /* Microscopic */

2025-03-07T03:22:19Z

Microscopic

← Older revision		Revision as of 03:22, 7 March 2025
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	*[[Benign clear cell clusters of the kidney]].		*[[Benign clear cell clusters of the kidney]].
	*[[Renal cell carcinoma with fibromyomatous stroma]].		*[[Renal cell carcinoma with fibromyomatous stroma]].
	*[[Hemangioblastoma of the kidney]] - especially in [[~~Von~~ Hippel-Lindau disease]].		*[[Hemangioblastoma of the kidney]] - especially in [[von Hippel-Lindau disease]].
	**S-100 +ve, inhibin +ve, PAX-8+ve, EMA -ve, CA9 -ve.		**S-100 +ve, inhibin +ve, PAX-8+ve, EMA -ve, CA9 -ve.

Michael at 03:21, 7 March 2025

2025-03-07T03:21:49Z

← Older revision		Revision as of 03:21, 7 March 2025
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	\| Micro = solid or [[trabecular]] pattern, polygonal cells usually with clear cytoplasm (may be eosinophilic - esp. in high grade tumours), central nucleus, delicate branching vasculature (chicken wire-like), +/-hyaline bodies		\| Micro = solid or [[trabecular]] pattern, polygonal cells usually with clear cytoplasm (may be eosinophilic - esp. in high grade tumours), central nucleus, delicate branching vasculature (chicken wire-like), +/-hyaline bodies
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[chromophobe renal cell carcinoma]], [[clear cell papillary renal cell tumour]], [[Xp11.2 translocation carcinoma]], [[ELOC-mutated renal cell carcinoma]], [[renal cell carcinoma with fibromyomatous stroma]], [[benign clear cell clusters of the kidney]], [[alveolar soft part sarcoma]], [[adrenocortical carcinoma]]		\| LMDDx = [[chromophobe renal cell carcinoma]], [[clear cell papillary renal cell tumour]], [[Xp11.2 translocation carcinoma]], [[ELOC-mutated renal cell carcinoma]], [[renal cell carcinoma with fibromyomatous stroma]], [[benign clear cell clusters of the kidney]], [[alveolar soft part sarcoma]], [[adrenocortical carcinoma]], [[hemangioblastoma of the kidney]]
	\| Stains = PAS +ve, PAS-D -ve, [[Hale's colloidal iron stain]] -ve		\| Stains = PAS +ve, PAS-D -ve, [[Hale's colloidal iron stain]] -ve
	\| IHC = [[CA9]] +ve, CK7 -ve, CK20 -ve, TFE3 -ve, PAX8 +ve, vimentin +ve		\| IHC = [[CA9]] +ve, CK7 -ve, CK20 -ve, TFE3 -ve, PAX8 +ve, vimentin +ve
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	*[[Benign clear cell clusters of the kidney]].		*[[Benign clear cell clusters of the kidney]].
	*[[Renal cell carcinoma with fibromyomatous stroma]].		*[[Renal cell carcinoma with fibromyomatous stroma]].
			*[[Hemangioblastoma of the kidney]] - especially in [[Von Hippel-Lindau disease]].
			**S-100 +ve, inhibin +ve, PAX-8+ve, EMA -ve, CA9 -ve.

	===Images===		===Images===

Michael at 17:23, 6 March 2025

2025-03-06T17:23:10Z

← Older revision		Revision as of 17:23, 6 March 2025
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	\| Micro = solid or [[trabecular]] pattern, polygonal cells usually with clear cytoplasm (may be eosinophilic - esp. in high grade tumours), central nucleus, delicate branching vasculature (chicken wire-like), +/-hyaline bodies		\| Micro = solid or [[trabecular]] pattern, polygonal cells usually with clear cytoplasm (may be eosinophilic - esp. in high grade tumours), central nucleus, delicate branching vasculature (chicken wire-like), +/-hyaline bodies
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[chromophobe renal cell carcinoma]], [[clear cell papillary renal cell ~~carcinoma~~]], [[Xp11.2 translocation carcinoma]], [[~~adrenocortical~~ carcinoma]], [[alveolar soft part sarcoma]]		\| LMDDx = [[chromophobe renal cell carcinoma]], [[clear cell papillary renal cell tumour]], [[Xp11.2 translocation carcinoma]], [[ELOC-mutated renal cell carcinoma]], [[renal cell carcinoma with fibromyomatous stroma]], [[benign clear cell clusters of the kidney]], [[alveolar soft part sarcoma]], [[adrenocortical carcinoma]]
	\| Stains = [[Hale's colloidal iron stain]] -ve		\| Stains = PAS +ve, PAS-D -ve, [[Hale's colloidal iron stain]] -ve
	\| IHC = [[CA9]] +ve, CK7 -ve, CK20 -ve, TFE3 -ve, PAX8 +ve, vimentin +ve		\| IHC = [[CA9]] +ve, CK7 -ve, CK20 -ve, TFE3 -ve, PAX8 +ve, vimentin +ve
	\| EM =		\| EM =

Michael: /* Stains */

2025-03-06T17:21:09Z

Stains

← Older revision		Revision as of 17:21, 6 March 2025
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	==Stains==		==Stains==
			*PAS +ve.
			*PAS-D -ve.<ref>{{cite journal \|authors=Kolečková M, Tichý T, Melichar B, Veverková L, Hes O, Kolek V, Kolář Z \|title=Metastatic Clear Cell Renal Carcinoma Without Evidence of a Primary Renal Tumour Mimicking Advanced Stage of Malignant Lung Tumour \|journal=Klin Onkol \|volume=32 \|issue=Supplementum1 \|pages=154–156 \|date=2019 \|pmid=31064187 \|doi= \|url=}}</ref><ref>{{cite journal \|authors=Liu S, Liu H, Weng B, Hou S \|title=Case report: Tongue metastasis as an initial sign of clear cell renal cell carcinoma and its prognosis \|journal=Front Oncol \|volume=14 \|issue= \|pages=1473211 \|date=2024 \|pmid=39931206 \|pmc=11807832 \|doi=10.3389/fonc.2024.1473211 \|url=}}</ref>
	*Hale's colloidal iron -ve.		*Hale's colloidal iron -ve.
	**+ve in [[chromophobe RCC]].		**+ve in [[chromophobe RCC]].
	*PAS +ve.
	*PAS-D -ve.


	Note:		Note:

Michael at 17:19, 6 March 2025

2025-03-06T17:19:10Z

← Older revision		Revision as of 17:19, 6 March 2025
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	DDx:		DDx:
	*[[Chromophobe renal cell carcinoma]].		*[[Chromophobe renal cell carcinoma]].
	*[[Clear cell papillary renal cell carcinoma]].		**Chromophobe: "translucent" (NOT quite clear), reticulated, Hale's colloidal iron stain+, CK7+ (cell membrane).
			*[[Clear cell papillary renal cell tumour]].
			*[[ELOC-mutated renal cell carcinoma]].
	*[[Xp11.2 translocation carcinoma]].		*[[Xp11.2 translocation carcinoma]].
	*[[Adrenocortical carcinoma]] (ACC)		*[[Adrenocortical carcinoma]] (ACC).
	**EMA -ve, CKs mostly -ve, inhibin +ve (neg. in RCC).<ref name=Ref_GUP285>{{Ref GUP\|285}}</ref>		**EMA -ve, CKs mostly -ve, inhibin +ve (neg. in RCC).<ref name=Ref_GUP285>{{Ref GUP\|285}}</ref>
	*[[Alveolar soft part sarcoma]].		*[[Alveolar soft part sarcoma]].
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	*[[Epithelioid angiomyolipoma]].		*[[Epithelioid angiomyolipoma]].
	*[[Benign clear cell clusters of the kidney]].		*[[Benign clear cell clusters of the kidney]].
			*[[Renal cell carcinoma with fibromyomatous stroma]].

	===Images===		===Images===
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	Note:		Note:
	*''[[Hale's colloidal iron]]'' does not stain iron... it stains hemosiderin.<ref>Latta. 27 January 2009.</ref>		*''[[Hale's colloidal iron]]'' does not stain iron... it stains hemosiderin.<ref>Latta. 27 January 2009.</ref>

	~~Clear cell vs. chromophobe:~~
	*Chromophobe: "translucent" (NOT quite clear), reticulated, Hale's colloidal iron stain+, CK7+ (cell membrane).

	==IHC==		==IHC==

Michael: /* Stains */

2025-03-06T17:17:20Z

Stains

← Older revision		Revision as of 17:17, 6 March 2025
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	*Hale's colloidal iron -ve.		*Hale's colloidal iron -ve.
	**+ve in [[chromophobe RCC]].		**+ve in [[chromophobe RCC]].
			*PAS +ve.
			*PAS-D -ve.

	Note: ''[[Hale's colloidal iron]]'' does not stain iron... it stains hemosiderin.<ref>Latta. 27 January 2009.</ref>
			Note:
			*''[[Hale's colloidal iron]]'' does not stain iron... it stains hemosiderin.<ref>Latta. 27 January 2009.</ref>

	Clear cell vs. chromophobe:		Clear cell vs. chromophobe:

Michael: benign clear cell clusters

2024-01-22T16:14:07Z

benign clear cell clusters

← Older revision		Revision as of 16:14, 22 January 2024
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	*[[Adrenal gland]], normal cortex - wispy, vacuolated.		*[[Adrenal gland]], normal cortex - wispy, vacuolated.
	*[[Epithelioid angiomyolipoma]].		*[[Epithelioid angiomyolipoma]].
			*[[Benign clear cell clusters of the kidney]].

	===Images===		===Images===

Michael: /* Resection */

2018-08-28T15:54:54Z

Resection

← Older revision		Revision as of 15:54, 28 August 2018
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	*The surgeon wants the diagnosis and margin status; thus, these are included in the diagnosis line with the tumour stage.		*The surgeon wants the diagnosis and margin status; thus, these are included in the diagnosis line with the tumour stage.

			<pre>
			Left Kidney, Radical Nephrectomy:
			- CLEAR CELL RENAL CELL CARCINOMA.
			-- Margins clear.
			-- Please see synoptic report.
			</pre>

			====Block letters====
	<pre>		<pre>
	KIDNEY, LEFT, NEPHRECTOMY:		KIDNEY, LEFT, NEPHRECTOMY:

Michael: /* General */

2018-08-09T13:37:50Z

General

← Older revision		Revision as of 13:37, 9 August 2018
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	*Various drugs.		*Various drugs.
	*Targeted therapies.		*Targeted therapies.
	**[[Tyrosine kinase inhibitors]] (e.g. sunitinib, sorafenib).<ref name=pmid25467013>{{Cite journal \| last1 = Elaidi \| first1 = R. \| last2 = Harbaoui \| first2 = A. \| last3 = Beuselinck \| first3 = B. \| last4 = Eymard \| first4 = JC. \| last5 = Bamias \| first5 = A. \| last6 = De Guillebon \| first6 = E. \| last7 = Porta \| first7 = C. \| last8 = Vano \| first8 = Y. \| last9 = Linassier \| first9 = C. \| title = Outcomes from second-line therapy in long-term responders to first-line tyrosine kinase inhibitor in clear-cell metastatic renal cell carcinoma. \| journal = Ann Oncol \| volume = 26 \| issue = 2 \| pages = 378-85 \| month = Feb \| year = 2015 \| doi = 10.1093/annonc/mdu552 \| PMID = 25467013 }}</ref><ref name=pmid21484781>{{Cite journal \| last1 = Verma \| first1 = J. \| last2 = Jonasch \| first2 = E. \| last3 = Allen \| first3 = P. \| last4 = Tannir \| first4 = N. \| last5 = Mahajan \| first5 = A. \| title = Impact of tyrosine kinase inhibitors on the incidence of brain metastasis in metastatic renal cell carcinoma. \| journal = Cancer \| volume = 117 \| issue = 21 \| pages = 4958-65 \| month = Nov \| year = 2011 \| doi = 10.1002/cncr.26138 \| PMID = 21484781 }}</ref>		**[[Tyrosine kinase inhibitors]] (e.g. [[sunitinib]], sorafenib).<ref name=pmid25467013>{{Cite journal \| last1 = Elaidi \| first1 = R. \| last2 = Harbaoui \| first2 = A. \| last3 = Beuselinck \| first3 = B. \| last4 = Eymard \| first4 = JC. \| last5 = Bamias \| first5 = A. \| last6 = De Guillebon \| first6 = E. \| last7 = Porta \| first7 = C. \| last8 = Vano \| first8 = Y. \| last9 = Linassier \| first9 = C. \| title = Outcomes from second-line therapy in long-term responders to first-line tyrosine kinase inhibitor in clear-cell metastatic renal cell carcinoma. \| journal = Ann Oncol \| volume = 26 \| issue = 2 \| pages = 378-85 \| month = Feb \| year = 2015 \| doi = 10.1093/annonc/mdu552 \| PMID = 25467013 }}</ref><ref name=pmid21484781>{{Cite journal \| last1 = Verma \| first1 = J. \| last2 = Jonasch \| first2 = E. \| last3 = Allen \| first3 = P. \| last4 = Tannir \| first4 = N. \| last5 = Mahajan \| first5 = A. \| title = Impact of tyrosine kinase inhibitors on the incidence of brain metastasis in metastatic renal cell carcinoma. \| journal = Cancer \| volume = 117 \| issue = 21 \| pages = 4958-65 \| month = Nov \| year = 2011 \| doi = 10.1002/cncr.26138 \| PMID = 21484781 }}</ref>
	**Anti-VEGF antibodies (e.g. bevacizumab).<ref name=pmid21330923>{{Cite journal \| last1 = Singer \| first1 = EA. \| last2 = Gupta \| first2 = GN. \| last3 = Srinivasan \| first3 = R. \| title = Update on targeted therapies for clear cell renal cell carcinoma. \| journal = Curr Opin Oncol \| volume = 23 \| issue = 3 \| pages = 283-9 \| month = May \| year = 2011 \| doi = 10.1097/CCO.0b013e32834479c0 \| PMID = 21330923 }}</ref>		**Anti-VEGF antibodies (e.g. bevacizumab).<ref name=pmid21330923>{{Cite journal \| last1 = Singer \| first1 = EA. \| last2 = Gupta \| first2 = GN. \| last3 = Srinivasan \| first3 = R. \| title = Update on targeted therapies for clear cell renal cell carcinoma. \| journal = Curr Opin Oncol \| volume = 23 \| issue = 3 \| pages = 283-9 \| month = May \| year = 2011 \| doi = 10.1097/CCO.0b013e32834479c0 \| PMID = 21330923 }}</ref>