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Difference between revisions of "Eosinophilic vacuolated tumour"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = High-grade oncocytic renal tumour -- high mag.jpg | |||
| Width = | |||
| Caption = Micrograph of a high-grade oncocytic tumour of the kidney. [[H&E stain]]. | |||
| Synonyms = high-grade oncocytic tumour | |||
| Micro = abundant oncocytic cytoplasm with prominent intracytoplasmic vacuoles, | |||
round nuclei, [[prominent nucleoli]] ([[ISUP nucleolar grade]] 3), no perinuclear halos | |||
| Subtypes = | |||
| LMDDx = [[renal oncocytoma]], [[renal hybrid oncocytic/chromophobe tumour]], [[chromophobe renal cell carcinoma]], other [[renal tumours with eosinophilic cytoplasm]] | |||
| Stains = | |||
| IHC = PAX8 +ve, CD117 +ve, CD10 +ve, SDHB +ve, TFE3 -ve | |||
| EM = | |||
| Molecular = TSC1 or TSC2 mutation | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Staging = | |||
| Site = [[kidney]] - see ''[[kidney tumours]]'' | |||
| Assdx = | |||
| Syndromes = [[tuberous sclerosis]] | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = very rare? (evolving entity) | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = unknown (evolving entity) | |||
| Other = | |||
| ClinDDx = other [[renal tumours]] | |||
| Tx = excision | |||
}} | |||
'''Eosinophilic vacuolated tumour''', abbreviated '''EVT''', is a [[kidney tumour]] type currently not recognized by the WHO classification as per the 2016 Blue Book. | |||
It was previously known as '''high-grade oncocytic tumour''', abbreviated '''HOT'''.<ref name=pmid34521993>{{cite journal |authors=Farcaş M, Gatalica Z, Trpkov K, Swensen J, Zhou M, Alaghehbandan R, Williamson SR, Magi-Galluzzi C, Gill AJ, Tretiakova M, Lopez JI, Montiel DP, Sperga M, Comperat E, Brimo F, Yilmaz A, Siadat F, Sangoi A, Gao Y, Ptákova N, Kuthi L, Pivovarcikova K, Rogala J, Agaimy A, Hartmann A, Fraune C, Rychly B, Hurnik P, Durcansky D, Bonert M, Gakis G, Michal M, Hora M, Hes O |title=Eosinophilic vacuolated tumor (EVT) of kidney demonstrates sporadic TSC/MTOR mutations: next-generation sequencing multi-institutional study of 19 cases |journal=Mod Pathol |volume= |issue= |pages= |date=September 2021 |pmid=34521993 |doi=10.1038/s41379-021-00923-6 |url=}}</ref> | |||
==General== | ==General== | ||
*Previously lumped into ''[[renal hybrid oncocytic/chromophobe tumour]]''. | *Previously lumped into ''[[renal hybrid oncocytic/chromophobe tumour]]''. | ||
*Evolving entity. | |||
*May be seen within the context of [[tuberous sclerosis]].<ref name=pmid31002177>{{Cite journal | last1 = Trpkov | first1 = K. | last2 = Bonert | first2 = M. | last3 = Gao | first3 = Y. | last4 = Kapoor | first4 = A. | last5 = He | first5 = H. | last6 = Yilmaz | first6 = A. | last7 = Gill | first7 = AJ. | last8 = Williamson | first8 = SR. | last9 = Comperat | first9 = E. | title = High-grade oncocytic tumour (HOT) of kidney in a patient with tuberous sclerosis complex. | journal = Histopathology | volume = | issue = | pages = | month = Apr | year = 2019 | doi = 10.1111/his.13876 | PMID = 31002177 }}</ref> | |||
==Microscopic== | ==Microscopic== | ||
Features:<ref name=pmid30232607>{{Cite journal | last1 = He | first1 = H. | last2 = Trpkov | first2 = K. | last3 = Martinek | first3 = P. | last4 = Isikci | first4 = OT. | last5 = Maggi-Galuzzi | first5 = C. | last6 = Alaghehbandan | first6 = R. | last7 = Gill | first7 = AJ. | last8 = Tretiakova | first8 = M. | last9 = Lopez | first9 = JI. | title = "High-grade oncocytic renal tumor": morphologic, immunohistochemical, and molecular genetic study of 14 cases. | journal = Virchows Arch | volume = 473 | issue = 6 | pages = 725-738 | month = Dec | year = 2018 | doi = 10.1007/s00428-018-2456-4 | PMID = 30232607 }}</ref> | Features:<ref name=pmid30232607>{{Cite journal | last1 = He | first1 = H. | last2 = Trpkov | first2 = K. | last3 = Martinek | first3 = P. | last4 = Isikci | first4 = OT. | last5 = Maggi-Galuzzi | first5 = C. | last6 = Alaghehbandan | first6 = R. | last7 = Gill | first7 = AJ. | last8 = Tretiakova | first8 = M. | last9 = Lopez | first9 = JI. | title = "High-grade oncocytic renal tumor": morphologic, immunohistochemical, and molecular genetic study of 14 cases. | journal = Virchows Arch | volume = 473 | issue = 6 | pages = 725-738 | month = Dec | year = 2018 | doi = 10.1007/s00428-018-2456-4 | PMID = 30232607 }}</ref> | ||
* | *Abundant oncocytic cytoplasm with prominent intracytoplasmic vacuoles. | ||
*Prominent nucleoli. | *Round nuclei | ||
**No "raisinoid" nuclei typical of [[chromophobe RCC]]. | |||
*Prominent nucleoli ([[ISUP nucleolar grade]] 3). | |||
*No perinuclear halos. | |||
DDx: | DDx: | ||
*[[Renal oncocytoma]]. | *[[Renal oncocytoma]]. | ||
*[[Renal hybrid oncocytic/chromophobe tumour]]. | *[[Renal hybrid oncocytic/chromophobe tumour]]. | ||
*[[ | *[[Chromophobe renal cell carcinoma]]. | ||
*Other [[renal tumours with eosinophilic cytoplasm]]. | |||
===Images=== | |||
<gallery> | |||
Image: High-grade oncocytic renal tumour -- low mag.jpg | HOT - low mag. (WC) | |||
Image: High-grade oncocytic renal tumour -- intermed mag.jpg | HOT - intermed. mag. (WC) | |||
Image: High-grade oncocytic renal tumour - alt -- intermed mag.jpg | HOT - intermed. mag. (WC) | |||
Image: High-grade oncocytic renal tumour -- high mag.jpg | HOT - high mag. (WC) | |||
Image: High-grade oncocytic renal tumour - alt -- high mag.jpg | HOT - high mag. (WC) | |||
Image: High-grade oncocytic renal tumour -- very high mag.jpg | HOT - very high mag. (WC) | |||
</gallery> | |||
==IHC== | |||
Features:<ref name=pmid30232607/> | |||
*PAX8 +ve. | |||
*AE1/AE3 +ve. | |||
*CK18 +ve. | |||
*SDHB +ve. | |||
*CD10 +ve (12 of 13 cases). | |||
*HMB45 -ve. | |||
*Melan A -ve. | |||
*TFE3 -ve. | |||
*[[CD117]] +ve (9 of 14 cases). | |||
Others: | |||
*CD56 +ve.{{fact}} | |||
**Typically negative in [[renal oncocytoma]]. | |||
==Molecular== | |||
*TSC1 or TSC2 mutation - see [[renal neoplasms with TSC/mTOR pathway mutations]]. | |||
==See also== | ==See also== | ||
| Line 18: | Line 88: | ||
==References== | ==References== | ||
{{Reflist| | {{Reflist|2}} | ||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||