Difference between revisions of "Renal oncocytosis"

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{{ Infobox diagnosis
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Name      = {{PAGENAME}}
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| Caption    =  
| Caption    =  
| Synonyms  =
| Synonyms  =
| Micro      =
| Micro      = any mixture of oncocytic tumours - see [[hybrid tumour]], [[chromophobe renal cell carcinoma]] (ChRCC) and [[renal oncocytoma]]; "in situ" oncocytic cells (outside of the tumour)
| Subtypes  =
| Subtypes  =
| LMDDx      = other [[renal tumours with eosinophilic cytoplasm]]
| LMDDx      = other [[renal tumours with eosinophilic cytoplasm]]
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| IHC        = characteristic of the histologic appearance - stain like oncocytoma, ChRCC and hybrid tumour
| IHC        = characteristic of the histologic appearance - stain like oncocytoma, ChRCC and hybrid tumour
| EM        =
| EM        =
| Molecular  =
| Molecular  = +/-gain of chromosome 5, do not typically have chromosomal losses seen in ChRCC
| IF        =
| IF        =
| Gross      = multiple brown kidney nodules (bilateral or unilateral)
| Gross      = multiple brown kidney nodules (bilateral or unilateral)
| Grossing  =
| Grossing  = [[total nephrectomy for tumour grossing]], [[partial nephrectomy grossing]]
| Staging    =
| Staging    = [[kidney cancer staging]]
| Site      = [[kidney]] - see ''[[kidney tumours]]''
| Site      = [[kidney]] - see ''[[kidney tumours]]''
| Assdx      =
| Assdx      =
| Syndromes  = [[Birt–Hogg–Dubé syndrome]]
| Syndromes  = [[Birt–Hogg–Dubé syndrome]]
| Clinicalhx =  
| Clinicalhx = +/-[[chronic renal failure]] and hemodialysis
| Signs      =
| Signs      =
| Symptoms  =
| Symptoms  =
| Prevalence = rare
| Prevalence = rare
| Bloodwork  =
| Bloodwork  =
| Rads      = multiple renal tumours
| Rads      = multiple renal tumours (unilateral or bilateral)
| Endoscopy  =
| Endoscopy  =
| Prognosis  =
| Prognosis  =
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*Rare.
*Rare.
*May be seen in the context of [[Birt–Hogg–Dubé syndrome]] or [[chronic renal failure]] or may be sporadic.<ref name=pmid23018240/>
*May be seen in the context of [[Birt–Hogg–Dubé syndrome]] or [[chronic renal failure]] or may be sporadic.<ref name=pmid23018240/>
**Chronic renal failure seen in 50% of cases in one series.<ref name=pmid21239013>{{Cite journal  | last1 = Adamy | first1 = A. | last2 = Lowrance | first2 = WT. | last3 = Yee | first3 = DS. | last4 = Chong | first4 = KT. | last5 = Bernstein | first5 = M. | last6 = Tickoo | first6 = SK. | last7 = Coleman | first7 = JA. | last8 = Russo | first8 = P. | title = Renal oncocytosis: management and clinical outcomes. | journal = J Urol | volume = 185 | issue = 3 | pages = 795-801 | month = Mar | year = 2011 | doi = 10.1016/j.juro.2010.10.068 | PMID = 21239013 }}</ref>


==Gross==
==Gross==
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Features:
Features:
*Any mixture of oncocytic tumours ([[hybrid tumour]], [[chromophobe renal cell carcinoma]], [[renal oncocytoma]]).
*Any mixture of oncocytic tumours ([[hybrid tumour]], [[chromophobe renal cell carcinoma]], [[renal oncocytoma]]).
*"In situ" oncocytic cells (similar to the tumour cells) within renal tubules.<ref name=pmid19636405>{{Cite journal  | last1 = Huang | first1 = J. | last2 = Lee | first2 = P. | last3 = Mikami | first3 = Y. | last4 = Melamed | first4 = J. | title = Dysplastic ("in-situ") Lesions in multofocal renal oncocytomas (oncocytosis). | journal = Int J Clin Exp Pathol | volume = 2 | issue = 6 | pages = 583-7 | month =  | year = 2009 | doi =  | PMID = 19636405 }}</ref>


DDx:
DDx:
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*[[Renal oncocytoma]].
*[[Renal oncocytoma]].
*Other [[renal tumours with eosinophilic cytoplasm]].
*Other [[renal tumours with eosinophilic cytoplasm]].
===Images===
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2713448/figure/fig01/ In situ oncocytosis (nih.gov)].<ref name=pmid19636405/>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2713448/figure/fig02/ In situ oncocytosis (nih.gov)].


==IHC==
==IHC==
*Characteristic of the histologic appearance.<ref name=pmid23018240/>
*Characteristic of the histologic appearance.<ref name=pmid23018240/>
*Stain like [[renal oncocytoma]]s, [[chromophobe renal cell carcinoma]]s and [[hybrid tumour]]s.  
*Stain like [[renal oncocytoma]]s, [[chromophobe renal cell carcinoma]]s and [[hybrid tumour]]s.
 
==Molecular==
*Scant data suggests chromosomal changes are seen that are different than those of [[ChRCC]] and [[oncocytoma]].<ref name=pmid20305535>{{Cite journal  | last1 = Gobbo | first1 = S. | last2 = Eble | first2 = JN. | last3 = Delahunt | first3 = B. | last4 = Grignon | first4 = DJ. | last5 = Samaratunga | first5 = H. | last6 = Martignoni | first6 = G. | last7 = Zhang | first7 = S. | last8 = Wang | first8 = M. | last9 = Brunelli | first9 = M. | title = Renal cell neoplasms of oncocytosis have distinct morphologic, immunohistochemical, and cytogenetic profiles. | journal = Am J Surg Pathol | volume = 34 | issue = 5 | pages = 620-6 | month = May | year = 2010 | doi = 10.1097/PAS.0b013e3181d73293 | PMID = 20305535 }}</ref>
**Do not have the chromosomal losses typical of ChRCC.
**May have gains in chromosome 5.
 
Note:
*ChRCC typically has loss of chromosomes: 1, 2, 6, 10, 13, 17, 21.<ref name=Ref_WMSP292>{{Ref WMSP|292}}</ref>


==See also==
==See also==
*[[Renal tumours]].
*[[Renal tumours]].
*[[Renal tumours with eosinophilic cytoplasm]].


==References==
==References==

Latest revision as of 16:02, 6 December 2015

Renal oncocytosis
Diagnosis in short

LM any mixture of oncocytic tumours - see hybrid tumour, chromophobe renal cell carcinoma (ChRCC) and renal oncocytoma; "in situ" oncocytic cells (outside of the tumour)
LM DDx other renal tumours with eosinophilic cytoplasm
IHC characteristic of the histologic appearance - stain like oncocytoma, ChRCC and hybrid tumour
Molecular +/-gain of chromosome 5, do not typically have chromosomal losses seen in ChRCC
Gross multiple brown kidney nodules (bilateral or unilateral)
Grossing notes total nephrectomy for tumour grossing, partial nephrectomy grossing
Staging kidney cancer staging
Site kidney - see kidney tumours

Syndromes Birt–Hogg–Dubé syndrome

Clinical history +/-chronic renal failure and hemodialysis
Prevalence rare
Radiology multiple renal tumours (unilateral or bilateral)
Clin. DDx metastatic disease, multifocal renal cell carcinoma

Renal oncocytosis is the presence of multiple oncocytic lesions within the kidney.[1]

General

Gross

  • Multiple (unilateral or bilateral) brown-coloured nodules.[1]

Microscopic

Features:

DDx:

Images

IHC

Molecular

  • Scant data suggests chromosomal changes are seen that are different than those of ChRCC and oncocytoma.[4]
    • Do not have the chromosomal losses typical of ChRCC.
    • May have gains in chromosome 5.

Note:

  • ChRCC typically has loss of chromosomes: 1, 2, 6, 10, 13, 17, 21.[5]

See also

References

  1. 1.0 1.1 1.2 1.3 Kuroda, N.; Tanaka, A.; Ohe, C.; Mikami, S.; Nagashima, Y.; Sasaki, T.; Inoue, K.; Hes, O. et al. (Nov 2012). "Review of renal oncocytosis (multiple oncocytic lesions) with focus on clinical and pathobiological aspects.". Histol Histopathol 27 (11): 1407-12. PMID 23018240.
  2. Adamy, A.; Lowrance, WT.; Yee, DS.; Chong, KT.; Bernstein, M.; Tickoo, SK.; Coleman, JA.; Russo, P. (Mar 2011). "Renal oncocytosis: management and clinical outcomes.". J Urol 185 (3): 795-801. doi:10.1016/j.juro.2010.10.068. PMID 21239013.
  3. 3.0 3.1 Huang, J.; Lee, P.; Mikami, Y.; Melamed, J. (2009). "Dysplastic ("in-situ") Lesions in multofocal renal oncocytomas (oncocytosis).". Int J Clin Exp Pathol 2 (6): 583-7. PMID 19636405.
  4. Gobbo, S.; Eble, JN.; Delahunt, B.; Grignon, DJ.; Samaratunga, H.; Martignoni, G.; Zhang, S.; Wang, M. et al. (May 2010). "Renal cell neoplasms of oncocytosis have distinct morphologic, immunohistochemical, and cytogenetic profiles.". Am J Surg Pathol 34 (5): 620-6. doi:10.1097/PAS.0b013e3181d73293. PMID 20305535.
  5. 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.