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Difference between revisions of "Papillary renal neoplasm with reverse polarity"
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Papillary renal neoplasm with reverse polarity (view source)
Revision as of 19:56, 17 June 2024
, 17 Juneno edit summary
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = | |||
| Width = | |||
| Caption = | |||
| Synonyms = | |||
| Micro = papillary structures, eosinophilic cytoplasm, reverse polarity of nuclei (nuclei at luminal aspect of cell), low nuclear grade | |||
| Subtypes = | |||
| LMDDx = eosinophilic [[papillary renal cell carcinoma]], other [[renal tumours with eosinophilic cytoplasm]] | |||
| Stains = | |||
| IHC = GATA3 +ve, PAX-8 +ve, CK7 +ve, CD10 +ve, CD117 -ve | |||
| EM = | |||
| Molecular = [[KRAS]] mutations | |||
| IF = | |||
| Gross = | |||
| Grossing = [[partial nephrectomy]], [[radical nephrectomy]] | |||
| Staging = | |||
| Site = [[kidney]] - see ''[[kidney tumours]]'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = rare | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = indolent - based on limited data | |||
| Other = | |||
| ClinDDx = other [[kidney tumours]] | |||
| Tx = | |||
}} | |||
'''Papillary renal neoplasm with reverse polarity''' is a rare [[renal tumour]] and evolving entity.<ref name=pmid31135486>{{cite journal |authors=Al-Obaidy KI, Eble JN, Cheng L, Williamson SR, Sakr WA, Gupta N, Idrees MT, Grignon DJ |title=Papillary Renal Neoplasm With Reverse Polarity: A Morphologic, Immunohistochemical, and Molecular Study |journal=Am J Surg Pathol |volume=43 |issue=8 |pages=1099–1111 |date=August 2019 |pmid=31135486 |doi=10.1097/PAS.0000000000001288 |url=}}</ref> | '''Papillary renal neoplasm with reverse polarity''' is a rare [[renal tumour]] and evolving entity.<ref name=pmid31135486>{{cite journal |authors=Al-Obaidy KI, Eble JN, Cheng L, Williamson SR, Sakr WA, Gupta N, Idrees MT, Grignon DJ |title=Papillary Renal Neoplasm With Reverse Polarity: A Morphologic, Immunohistochemical, and Molecular Study |journal=Am J Surg Pathol |volume=43 |issue=8 |pages=1099–1111 |date=August 2019 |pmid=31135486 |doi=10.1097/PAS.0000000000001288 |url=}}</ref> | ||
==General== | ==General== | ||
*Evolving entity. | *Evolving entity. | ||
* | *Thought to be distinct from ''eosinophilic [[papillary renal cell carcinoma]]''.<ref name=pmid38456605>{{cite journal |authors=Castillo VF, Trpkov K, Van der Kwast T, Rotondo F, Hamdani M, Saleeb R |title=Papillary renal neoplasm with reverse polarity is biologically and clinically distinct from eosinophilic papillary renal cell carcinoma |journal=Pathol Int |volume=74 |issue=4 |pages=222–226 |date=April 2024 |pmid=38456605 |doi=10.1111/pin.13417 |url=}}</ref><ref name=pmid37797754>{{cite journal |authors=Kim B, Lee S, Moon KC |title=Papillary renal neoplasm with reverse polarity: a clinicopathologic study of 43 cases with a focus on the expression of KRAS signaling pathway downstream effectors |journal=Hum Pathol |volume=142 |issue= |pages=1–6 |date=December 2023 |pmid=37797754 |doi=10.1016/j.humpath.2023.09.011 |url=}}</ref> | ||
*Early data suggests an indolent behaviour.<ref name=pmid31135486>{{cite journal |authors=Al-Obaidy KI, Eble JN, Cheng L, Williamson SR, Sakr WA, Gupta N, Idrees MT, Grignon DJ |title=Papillary Renal Neoplasm With Reverse Polarity: A Morphologic, Immunohistochemical, and Molecular Study |journal=Am J Surg Pathol |volume=43 |issue=8 |pages=1099–1111 |date=August 2019 |pmid=31135486 |doi=10.1097/PAS.0000000000001288 |url=}}</ref> | |||
==Micro== | ==Micro== | ||
| Line 16: | Line 49: | ||
DDx: | DDx: | ||
*Eosinophilic [[papillary renal cell carcinoma]] - considered distinct from this entity. | |||
*[[Renal tumours with eosinophilic cytoplasm]]. | *[[Renal tumours with eosinophilic cytoplasm]]. | ||
| Line 28: | Line 62: | ||
*EMA +ve. | *EMA +ve. | ||
*L1CAM +ve. | *L1CAM +ve. | ||
==Molecular== | |||
*[[KRAS]] mutations.<ref name=pmid37797754/> | |||
==Sign out== | |||
<pre> | |||
A. Right Kidney, Tumour, Partial Nephrectomy: | |||
- Papillary renal neoplasm with reverse polarity, clear of margin, see comment. | |||
Comment: | |||
The tumour has a papillary architecture, eosinophilic cytoplasm, low nuclear grade, and reversed nuclear polarity. | |||
It stains as follows: | |||
POSITIVE: PAX8 (moderate, diffuse), CK7 (strong, diffuse), AE1/AE3 (strong, diffuse), GATA3 (moderate, diffuse), AMACR (moderate, diffuse). | |||
NEGATIVE: vimentin (stroma), CD117, CD10. | |||
PRNRP is thought to be distinct from papillary RCC.[1][2] Limited data suggests PRNRP has an indolent behaviour.[3] Follow-up is recommended. | |||
1. Pathol Int. 2024 Apr;74(4):222-226. doi: 10.1111/pin.13417. https://pubmed.ncbi.nlm.nih.gov/38456605/ | |||
2. Hum Pathol. 2023 Dec:142:1-6. doi: 10.1016/j.humpath.2023.09.011. https://pubmed.ncbi.nlm.nih.gov/37797754/ | |||
3. Am J Surg Pathol. 2019 Aug;43(8):1099-1111. doi: 10.1097/PAS.0000000000001288. https://pubmed.ncbi.nlm.nih.gov/31135486/ | |||
</pre> | |||
==See also== | ==See also== | ||
| Line 33: | Line 89: | ||
==References== | ==References== | ||
{{Reflist| | {{Reflist|2}} | ||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Kidney tumours]] | |||