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Difference between revisions of "Renal oncocytoma"
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'''Renal oncocytoma''' is a benign [[kidney tumour]] that is removed to exclude malignancy. | |||
==General== | |||
*Can be difficult to distinguish radiologically from RCC (chromophobe subtype). | |||
** ... and pathologists occasionally struggle like the radiologists. | |||
*Benign tumour - the reason it is excised is... one cannot be certain it isn't a RCC. | |||
==Gross== | |||
*Brown, mahogany brown. | |||
*1/3 have a characteristic central scar.<ref name=Ref_GUP302>{{Ref GUP|302}}</ref> | |||
===Image=== | |||
<gallery> | |||
Image:Renal_oncocytoma.jpg| Renal oncocytoma with central scar. (WP) | |||
</gallery> | |||
==Microscopic== | |||
Features: | |||
*Eosinophilic cytoplasm - slightly granular '''key feature'''. | |||
*Cells arranged in nests. | |||
*Nuclei uniform and round.<ref name=Ref_GUP302>{{Ref GUP|302}}</ref> | |||
**Slightly enlarged nuclei, but '''no significant''' pleomorphism (size variation) - '''important'''. | |||
Notes: | |||
*May look like eosinophilic variant of chromophobe RCC -- this is the main DDx. | |||
**A comparison based on histomorphology: ''[[Kidney_tumours#Tabular_comparison_of_oncocytoma_and_chromophobe_RCC|Tabular comparison between ChRCC & oncocytoma]]''. | |||
***Oncocytoma typically has: no perinuclear clearing, no raisinoid nuclei, no binucleation. | |||
DDx: | |||
*[[Chromophobe renal cell carcinoma]], eosinophilic variant. | |||
*[[Clear cell renal cell carcinoma]], eosinophilic variant. | |||
===Images=== | |||
<gallery> | |||
Image:Renal_oncocytoma2.jpg | Oncocytoma - high mag. (WC/Nephron) | |||
Image:Renal_oncocytoma3.jpg | Oncocytoma - intermed. mag. (WC/Nephron) | |||
Image:Renal_oncocytoma4.jpg | Oncocytoma - low mag. (WC/Nephron) | |||
</gallery> | |||
==Stain=== | |||
*[[Hale's colloidal iron]] -ve | |||
**[[ChRCC]] +ve (blue granular cytoplasmic). | |||
===IHC=== | |||
*CK7 -ve<ref name=pmid17683191>{{Cite journal | last1 = Liu | first1 = L. | last2 = Qian | first2 = J. | last3 = Singh | first3 = H. | last4 = Meiers | first4 = I. | last5 = Zhou | first5 = X. | last6 = Bostwick | first6 = DG. | title = Immunohistochemical analysis of chromophobe renal cell carcinoma, renal oncocytoma, and clear cell carcinoma: an optimal and practical panel for differential diagnosis. | journal = Arch Pathol Lab Med | volume = 131 | issue = 8 | pages = 1290-7 | month = Aug | year = 2007 | doi = 10.1043/1543-2165(2007)131[1290:IAOCRC]2.0.CO;2 | PMID = 17683191 }}</ref>/+ve (cytoplasmic) . | |||
**Chromophobe renal cell carcinoma = cell membrane +ve. | |||
==Sign out== | |||
<pre> | |||
PORTION OF KIDNEY, RIGHT, PARTIAL NEPHRECTOMY: | |||
- ONCOCYTOMA. | |||
</pre> | |||
===Micro=== | |||
The sections show a tumour with cells arranged in nests. The tumour cells have abundant | |||
eosinophilic cytoplasm. The tumour cell nuclei are round and have round nucleoli. No | |||
perinuclear halos are apparent. Binucleation is not apparent. No zonal necrosis is | |||
identified. Focally, tumour nests are spaced reminiscent of an archipelago. Mitoses are not | |||
apparent. The tumour is moderately circumscribed. | |||
The thin rim of renal parenchyma has no apparent pathology on the H&E stained sections. | |||
==See also== | |||
*[[Kidney tumours]]. | |||
*[[Oncocytoma]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Kidney tumours]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||