Difference between revisions of "Chromophobe renal cell carcinoma"

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*CK7 +ve cell membrane.<ref name=Ref_GUP293>{{Ref GUP|293}}</ref>
*CK7 +ve cell membrane.<ref name=Ref_GUP293>{{Ref GUP|293}}</ref>
*CD117 +ve.
*CD117 +ve.
*Vimentin -ve.
*Vimentin -ve.<ref name=pmid22455881>{{Cite journal  | last1 = Zhang | first1 = W. | last2 = Yu | first2 = WJ. | last3 = Jiang | first3 = YX. | last4 = Li | first4 = YJ. | last5 = Han | first5 = F. | last6 = Liu | first6 = Y. | last7 = Han | first7 = ZL. | title = [Chromophobe renal cell carcinoma: a clinicopathologic study and immunophenotypes of 42 cases]. | journal = Zhonghua Bing Li Xue Za Zhi | volume = 41 | issue = 2 | pages = 76-80 | month = Feb | year = 2012 | doi =  | PMID = 22455881 }}
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==Molecular==
==Molecular==

Revision as of 17:07, 6 December 2013

Chromophobe renal cell carcinoma
Diagnosis in short

Eosinophilic variant of chromophobe renal cell carcinoma. H&E stain.
LM pale cytoplasm, with wisps of eosinophilic material, perinuclear clearing (a pale halo surrounds the nucleus), periphery of cell distinct (cell membrane is easy to discern -- plant cell-like)
Subtypes eosinophilic variant
LM DDx clear cell renal cell carcinoma (classic), renal oncocytoma, clear cell renal cell carcinoma eosinophilic variant
Stains Hale's colloidal iron +ve
IHC CK7 +ve cell membrane, CD117 +ve, vimentin -ve
Site kidney - see renal tumours
Syndromes Birt–Hogg–Dubé syndrome
Prevalence relatively common

Chromophobe renal cell carcinoma, abbreviated ChRCC, is a relatively common form of renal cell carcinoma.

General

There are two subtypes:[3]

  • Classic.
  • Eosinophilic variant.

Gross

  • Tan, light-brown.
  • Solitary.
  • Well-circumscribed.

Image:

Microscopic

Classic

Features - classic type (3 P's mnemonic):[4][3]

  • Pale cytoplasm, with wisps of eosinophilic material; the cells are not completely clear, they have "cobwebs".
  • Perinuclear clearing, i.e. a pale halo surrounds the nucleus - key feature.
  • Periphery of cell distinct, i.e. cell membrane is easy to discern.

Notes:

  • May have psammoma bodies.
  • May be described as "plant-like"; plant cells have (thick) cell walls.
  • The perinuclear clearing is often somewhat patchy, i.e. it is usually not present in very tumour cell.

DDx:

  • Clear cell RCC (classic).
    • Perinuclear clearing is not seen in clear cell RCC.
    • ChRCC has wisps in the cytoplasm.

Eosinophilic variant

Features - eosinophilic variant:[3]

  • Eosinophilic (finely granular) cytoplasm.
  • Perinuclear clearing - key feature.
  • Periphery of cell distinct.
  • Smaller cells than classic subtype.

Notes:

  1. May have psammoma bodies.

DDx:

  1. Oncocytoma - particularly the eosinophilic variant.
    • IHC may be useful to differentiate (CK7: oncocytoma = cytoplasm +ve, chromophobe = cell membrane +ve).
    • A comparison based on histomorphology: Tabular comparison between ChRCC & oncocytoma.
      • Oncocytoma typically has: no perinuclear clearing, no raisinoid nuclei, no binucleation.
  2. Clear cell RCC, eosinophilic variant.
    • Perinuclear clearing is not seen in clear cell RCC.
    • ChRCC has wisps in the cytoplasm.

Image

  • Eosinophilic chromophobe RCC. (WC/Nephron)

www:

Stains

Images:

IHC

  • CK7 +ve cell membrane.[3]
  • CD117 +ve.
  • Vimentin -ve.[6]

Molecular

  • Extensive aneusomy (monosomy?):[7]
    • Loss of chromosomes: 1, 2, 6, 10, 13, 17, 21.

Sign out

KIDNEY, RIGHT UPPER POLE, PARTIAL NEPHRECTOMY:
- CHROMOPHOBE RENAL CELL CARCINOMA.

COMMENT:
The sections show a mix of clear cells with wispy cytoplasm, and cells with eosinophilic
cytoplasm and perinuclear halos. There are no true papillae. 

Stains and immunostains:
Positive: CK7, CAM5.2, EMA, pankeratin, CD117, colloidal iron.
Negative: AMACR, CD10, CD68, RCC, vimentin.

See also

References

  1. ↑ Delahunt, B.; Sika-Paotonu, D.; Bethwaite, PB.; McCredie, MR.; Martignoni, G.; Eble, JN.; Jordan, TW. (Jun 2007). "Fuhrman grading is not appropriate for chromophobe renal cell carcinoma.". Am J Surg Pathol 31 (6): 957-60. doi:10.1097/01.pas.0000249446.28713.53. PMID 17527087.
  2. ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 290. ISBN 978-0781765275.
  3. ↑ 3.0 3.1 3.2 3.3 Zhou, Ming; Magi-Galluzzi, Cristina (2006). Genitourinary Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 293. ISBN 978-0443066771.
  4. ↑ Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 1016-7. ISBN 0-7216-0187-1.
  5. ↑ URL: http://www.ultrapath.org/oldsite/cases99/sep99/cotm9-2.html. Accessed on: 9 October 2011.
  6. ↑ Zhang, W.; Yu, WJ.; Jiang, YX.; Li, YJ.; Han, F.; Liu, Y.; Han, ZL. (Feb 2012). "[Chromophobe renal cell carcinoma: a clinicopathologic study and immunophenotypes of 42 cases].". Zhonghua Bing Li Xue Za Zhi 41 (2): 76-80. PMID 22455881.
  7. ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 292. ISBN 978-0781765275.
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