Papillary renal cell carcinoma: Difference between revisions
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===Histological subtyping | ===Histological subtyping=== | ||
====Historical type 1 and type 2==== | |||
Historically, PaRCC was subtyped:<ref name=Ref_GUP289>{{Ref GUP|289}}</ref><ref>{{Cite journal | last1 = Delahunt | first1 = B. | last2 = Eble | first2 = JN. | title = Papillary renal cell carcinoma: a clinicopathologic and immunohistochemical study of 105 tumors. | journal = Mod Pathol | volume = 10 | issue = 6 | pages = 537-44 | month = Jun | year = 1997 | doi = | PMID = 9195569 }}</ref> | Historically, PaRCC was subtyped:<ref name=Ref_GUP289>{{Ref GUP|289}}</ref><ref>{{Cite journal | last1 = Delahunt | first1 = B. | last2 = Eble | first2 = JN. | title = Papillary renal cell carcinoma: a clinicopathologic and immunohistochemical study of 105 tumors. | journal = Mod Pathol | volume = 10 | issue = 6 | pages = 537-44 | month = Jun | year = 1997 | doi = | PMID = 9195569 }}</ref> | ||
*''Type 1'' - single layer of cells on basement membrane - '''most important'''. | *''Type 1'' - single layer of cells on basement membrane - '''most important'''. | ||
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The WHO GU Blue Book 5th Ed. recommends against subtyping. | The WHO GU Blue Book 5th Ed. recommends against subtyping. | ||
How are ''Type 1'' and ''Type 2'' now classified? | |||
*The defunct ''Type 1'' is ''papillary renal cell carcinoma''. It is classically associated with a MET gene alteration. | *The defunct ''Type 1'' is ''papillary renal cell carcinoma''. It is classically associated with a MET gene alteration. | ||
*The defunct ''Type 2'' is a mix of different RCCs, e.g. ALK-RCC, translocation RCC, FH-deficient RCC. | *The defunct ''Type 2'' is a mix of different RCCs, e.g. ALK-RCC, translocation RCC, FH-deficient RCC. | ||
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Others: | Others: | ||
*GATA3 +ve - oncocytic variant of PaRCC; negative in other PaRCC subtypes.<ref name=pmid28984673>{{cite journal |authors=Saleeb RM, Brimo F, Farag M, Rompré-Brodeur A, Rotondo F, Beharry V, Wala S, Plant P, Downes MR, Pace K, Evans A, Bjarnason G, Bartlett JMS, Yousef GM |title=Toward Biological Subtyping of Papillary Renal Cell Carcinoma With Clinical Implications Through Histologic, Immunohistochemical, and Molecular Analysis |journal=Am J Surg Pathol |volume=41 |issue=12 |pages=1618–1629 |date=December 2017 |pmid=28984673 |doi=10.1097/PAS.0000000000000962 |url=}}</ref> | *[[GATA3]] +ve - oncocytic variant of PaRCC; negative in other PaRCC subtypes.<ref name=pmid28984673>{{cite journal |authors=Saleeb RM, Brimo F, Farag M, Rompré-Brodeur A, Rotondo F, Beharry V, Wala S, Plant P, Downes MR, Pace K, Evans A, Bjarnason G, Bartlett JMS, Yousef GM |title=Toward Biological Subtyping of Papillary Renal Cell Carcinoma With Clinical Implications Through Histologic, Immunohistochemical, and Molecular Analysis |journal=Am J Surg Pathol |volume=41 |issue=12 |pages=1618–1629 |date=December 2017 |pmid=28984673 |doi=10.1097/PAS.0000000000000962 |url=}}</ref> | ||
*ABCC2 brush border staining = worse survival.<ref name=pmid37680023>{{cite journal |authors=Castillo VF, Masoomian M, Trpkov K, Downes M, Brimo F, van der Kwast T, Yousef GM, Zakhary A, Rotondo F, Saad G, Nguyen VN, Kidanewold W, Streutker C, Rowsell C, Hamdani M, Saleeb RM |title=ABCC2 brush-border expression predicts outcome in papillary renal cell carcinoma: a multi-institutional study of 254 cases |journal=Histopathology |volume=83 |issue=6 |pages=949–958 |date=December 2023 |pmid=37680023 |doi=10.1111/his.15042 |url=}}</ref> | *[[ABCC2]] brush border staining = worse survival.<ref name=pmid37680023>{{cite journal |authors=Castillo VF, Masoomian M, Trpkov K, Downes M, Brimo F, van der Kwast T, Yousef GM, Zakhary A, Rotondo F, Saad G, Nguyen VN, Kidanewold W, Streutker C, Rowsell C, Hamdani M, Saleeb RM |title=ABCC2 brush-border expression predicts outcome in papillary renal cell carcinoma: a multi-institutional study of 254 cases |journal=Histopathology |volume=83 |issue=6 |pages=949–958 |date=December 2023 |pmid=37680023 |doi=10.1111/his.15042 |url=}}</ref> | ||
Metanephric adenoma vs. PaRCC type 1:<ref name=pmid24083046>{{Cite journal | last1 = Watanabe | first1 = S. | last2 = Naganuma | first2 = H. | last3 = Shimizu | first3 = M. | last4 = Ota | first4 = S. | last5 = Murata | first5 = S. | last6 = Nihei | first6 = N. | last7 = Matsushima | first7 = J. | last8 = Mikami | first8 = S. | last9 = Kuroda | first9 = N. | title = Adult nephroblastoma with predominant epithelial component: a differential diagnostic candidate of papillary renal cell carcinoma and metanephric adenoma-report of three cases. | journal = Case Rep Pathol | volume = 2013 | issue = | pages = 675875 | month = | year = 2013 | doi = 10.1155/2013/675875 | PMID = 24083046 }}</ref> | Metanephric adenoma vs. PaRCC type 1:<ref name=pmid24083046>{{Cite journal | last1 = Watanabe | first1 = S. | last2 = Naganuma | first2 = H. | last3 = Shimizu | first3 = M. | last4 = Ota | first4 = S. | last5 = Murata | first5 = S. | last6 = Nihei | first6 = N. | last7 = Matsushima | first7 = J. | last8 = Mikami | first8 = S. | last9 = Kuroda | first9 = N. | title = Adult nephroblastoma with predominant epithelial component: a differential diagnostic candidate of papillary renal cell carcinoma and metanephric adenoma-report of three cases. | journal = Case Rep Pathol | volume = 2013 | issue = | pages = 675875 | month = | year = 2013 | doi = 10.1155/2013/675875 | PMID = 24083046 }}</ref> | ||
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Multiple small lesions, like the largest tumour, less than 1.5 cm are present. | Multiple small lesions, like the largest tumour, less than 1.5 cm are present. | ||
=====Alternate===== | |||
The sections show a tumour in the kidney with fibrovascular cores (papillae) that contain macrophages. The papillae predominantly have a single layer of tumour cells. Nucleoli are not prominent with the 10x objective (ISUP nucleolar grade 2). | |||
===Oncocytic variant=== | ===Oncocytic variant=== | ||