Difference between revisions of "Acquired cystic disease-associated renal cell carcinoma"

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m (oxylate -> oxalate)
 
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| Caption    = Acquired cystic disease-associated renal cell carcinoma. [[H&E stain]].
| Caption    = Acquired cystic disease-associated renal cell carcinoma. [[H&E stain]].
| Synonyms  =
| Synonyms  =
| Micro      = sieve-like architecture (tubular structures/cribriforming), tumour cells with prominent nucleoli and eosinophilic cytoplasm, oxylate crystals - seen best in [[polarized light]], acquired cystic disease in background, +/-papillary structures - common minor component
| Micro      = sieve-like architecture (tubular structures/cribriforming), tumour cells with prominent nucleoli and eosinophilic cytoplasm, oxalate crystals - seen best in [[polarized light]], acquired cystic disease in background, +/-papillary structures - common minor component
| Subtypes  =
| Subtypes  =
| LMDDx      = [[acquired cystic renal disease]], [[papillary renal cell carcinoma]], [[hereditary leiomyomatosis renal cell carcinoma syndrome associated renal cell carcinoma]]
| LMDDx      = [[acquired cystic renal disease]], [[papillary renal cell carcinoma]], [[hereditary leiomyomatosis renal cell carcinoma syndrome associated renal cell carcinoma]]
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==General==
==General==
*Arise in the context of [[acquired cystic disease of the kidney]] which is seen in the context of [[end-stage renal disease]] (ESRD).<ref name=pmid23471757>{{Cite journal  | last1 = Ahn | first1 = S. | last2 = Kwon | first2 = GY. | last3 = Cho | first3 = YM. | last4 = Jun | first4 = SY. | last5 = Choi | first5 = C. | last6 = Kim | first6 = HJ. | last7 = Park | first7 = YW. | last8 = Park | first8 = WS. | last9 = Shim | first9 = JW. | title = Acquired cystic disease-associated renal cell carcinoma: further characterization of the morphologic and immunopathologic features. | journal = Med Mol Morphol | volume =  | issue =  | pages =  | month = Mar | year = 2013 | doi = 10.1007/s00795-013-0028-x | PMID = 23471757 }}</ref>
*Arise in the context of [[acquired cystic disease of the kidney]] which is seen in the context of [[end-stage renal disease]] (ESRD).<ref name=pmid23471757>{{Cite journal  | last1 = Ahn | first1 = S. | last2 = Kwon | first2 = GY. | last3 = Cho | first3 = YM. | last4 = Jun | first4 = SY. | last5 = Choi | first5 = C. | last6 = Kim | first6 = HJ. | last7 = Park | first7 = YW. | last8 = Park | first8 = WS. | last9 = Shim | first9 = JW. | title = Acquired cystic disease-associated renal cell carcinoma: further characterization of the morphologic and immunopathologic features. | journal = Med Mol Morphol | volume =  | issue =  | pages =  | month = Mar | year = 2013 | doi = 10.1007/s00795-013-0028-x | PMID = 23471757 }}</ref>
*Described in 2006 by Tickoo ''et al''.<ref name=pmid16434887>{{Cite journal  | last1 = Tickoo | first1 = SK. | last2 = dePeralta-Venturina | first2 = MN. | last3 = Harik | first3 = LR. | last4 = Worcester | first4 = HD. | last5 = Salama | first5 = ME. | last6 = Young | first6 = AN. | last7 = Moch | first7 = H. | last8 = Amin | first8 = MB. | title = Spectrum of epithelial neoplasms in end-stage renal disease: an experience from 66 tumor-bearing kidneys with emphasis on histologic patterns distinct from those in sporadic adult renal neoplasia. | journal = Am J Surg Pathol | volume = 30 | issue = 2 | pages = 141-53 | month = Feb | year = 2006 | doi =  | PMID = 16434887 }}</ref>
*May have aggressive course - including [[lymph node metastases]] and death.<ref name=pmid16434887>{{Cite journal  | last1 = Tickoo | first1 = SK. | last2 = dePeralta-Venturina | first2 = MN. | last3 = Harik | first3 = LR. | last4 = Worcester | first4 = HD. | last5 = Salama | first5 = ME. | last6 = Young | first6 = AN. | last7 = Moch | first7 = H. | last8 = Amin | first8 = MB. | title = Spectrum of epithelial neoplasms in end-stage renal disease: an experience from 66 tumor-bearing kidneys with emphasis on histologic patterns distinct from those in sporadic adult renal neoplasia. | journal = Am J Surg Pathol | volume = 30 | issue = 2 | pages = 141-53 | month = Feb | year = 2006 | doi =  | PMID = 16434887 }}</ref>


==Gross==
==Gross==
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**Focal papillary architecture - common.<ref name=pmid16434887>{{Cite journal  | last1 = Tickoo | first1 = SK. | last2 = dePeralta-Venturina | first2 = MN. | last3 = Harik | first3 = LR. | last4 = Worcester | first4 = HD. | last5 = Salama | first5 = ME. | last6 = Young | first6 = AN. | last7 = Moch | first7 = H. | last8 = Amin | first8 = MB. | title = Spectrum of epithelial neoplasms in end-stage renal disease: an experience from 66 tumor-bearing kidneys with emphasis on histologic patterns distinct from those in sporadic adult renal neoplasia. | journal = Am J Surg Pathol | volume = 30 | issue = 2 | pages = 141-53 | month = Feb | year = 2006 | doi =  | PMID = 16434887 }}</ref>
**Focal papillary architecture - common.<ref name=pmid16434887>{{Cite journal  | last1 = Tickoo | first1 = SK. | last2 = dePeralta-Venturina | first2 = MN. | last3 = Harik | first3 = LR. | last4 = Worcester | first4 = HD. | last5 = Salama | first5 = ME. | last6 = Young | first6 = AN. | last7 = Moch | first7 = H. | last8 = Amin | first8 = MB. | title = Spectrum of epithelial neoplasms in end-stage renal disease: an experience from 66 tumor-bearing kidneys with emphasis on histologic patterns distinct from those in sporadic adult renal neoplasia. | journal = Am J Surg Pathol | volume = 30 | issue = 2 | pages = 141-53 | month = Feb | year = 2006 | doi =  | PMID = 16434887 }}</ref>
**Tumour cells have prominent nucleoli ([[ISUP nucleolar grade]] 3) and eosinophilic cytoplasm.
**Tumour cells have prominent nucleoli ([[ISUP nucleolar grade]] 3) and eosinophilic cytoplasm.
*Oxylate crystals - '''important'''.
*Oxalate crystals - '''important'''.
**Look somewhat like cholesterol clefts.
**Look somewhat like cholesterol clefts.
**Seen easily in [[polarized light]].
**Seen easily in [[polarized light]].

Latest revision as of 23:37, 26 May 2018

Acquired cystic disease-associated renal cell carcinoma
Diagnosis in short

Acquired cystic disease-associated renal cell carcinoma. H&E stain.
LM sieve-like architecture (tubular structures/cribriforming), tumour cells with prominent nucleoli and eosinophilic cytoplasm, oxalate crystals - seen best in polarized light, acquired cystic disease in background, +/-papillary structures - common minor component
LM DDx acquired cystic renal disease, papillary renal cell carcinoma, hereditary leiomyomatosis renal cell carcinoma syndrome associated renal cell carcinoma
IHC AMACR +ve, CD10 +ve, pankeratin +ve, CK7 +ve (heterogeneous), EMA -ve
Gross kidney with cystic changes, thinned cortex
Grossing notes total nephrectomy for tumour grossing, partial nephrectomy grossing
Staging kidney cancer staging
Site kidney - see kidney tumours
Associated Dx acquired cystic disease of the kidney, end-stage renal disease
Prevalence rare
Radiology renal mass and cysts
Treatment nephrectomy

Acquired cystic disease-associated renal cell carcinoma, abbreviated ACD-RCC, is a rare kidney cancer that arises in the context of chronic renal failure.

It was added to the WHO classification of renal neoplasia in the Vancouver modification of 2012/2013.[1]

General

Gross

  • Cysts.

Microscopic

Features:

  • Fused tubular structures/cribriforming/sieve-like architecture.[4]
    • Focal papillary architecture - common.[3]
    • Tumour cells have prominent nucleoli (ISUP nucleolar grade 3) and eosinophilic cytoplasm.
  • Oxalate crystals - important.
  • Acquired cystic disease in background - required.
    • Changes of end-stage kidney (obsolete glomeruli, thyroidization, interstitial fibrosis).

DDx:

Images

Case

  • ACD-RCC - very low mag.

  • ACD-RCC - low mag.

  • ACD-RCC - intermed. mag.

  • ACD-RCC - intermed. mag.

  • ACD-RCC - high mag.

  • ACD-RCC - very high mag.

  • ACD-RCC - low mag.

  • ACD-RCC - intermed. mag.

  • ACD-RCC - intermed. mag.

  • ACD-RCC - high mag.

  • ACD-RCC - high mag.

  • ACD-RCC - very high mag.

  • ACD-RCC - very high mag.

  • ACD-RCC with and without polarized light - intermed. mag.

www

IHC

Features:[2]

  • AMACR +ve.
  • CD10 +ve.
  • Pankeratin +ve.
  • CK7 +ve (heterogeneous).

Others:[2]

  • CD68 -ve.
  • PAX2 -ve.
  • EMA -ve.[6]
  • HMWCK -ve.[6]
  • Vimentin +ve/-ve.[6]
  • CAM5.2 +ve/-ve.[6]

See also

References

  1. ↑ Srigley, JR.; Delahunt, B.; Eble, JN.; Egevad, L.; Epstein, JI.; Grignon, D.; Hes, O.; Moch, H. et al. (Oct 2013). "The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia.". Am J Surg Pathol 37 (10): 1469-89. doi:10.1097/PAS.0b013e318299f2d1. PMID 24025519.
  2. ↑ 2.0 2.1 2.2 Ahn, S.; Kwon, GY.; Cho, YM.; Jun, SY.; Choi, C.; Kim, HJ.; Park, YW.; Park, WS. et al. (Mar 2013). "Acquired cystic disease-associated renal cell carcinoma: further characterization of the morphologic and immunopathologic features.". Med Mol Morphol. doi:10.1007/s00795-013-0028-x. PMID 23471757.
  3. ↑ 3.0 3.1 Tickoo, SK.; dePeralta-Venturina, MN.; Harik, LR.; Worcester, HD.; Salama, ME.; Young, AN.; Moch, H.; Amin, MB. (Feb 2006). "Spectrum of epithelial neoplasms in end-stage renal disease: an experience from 66 tumor-bearing kidneys with emphasis on histologic patterns distinct from those in sporadic adult renal neoplasia.". Am J Surg Pathol 30 (2): 141-53. PMID 16434887.
  4. ↑ Srigley, JR.; Delahunt, B.; Eble, JN.; Egevad, L.; Epstein, JI.; Grignon, D.; Hes, O.; Moch, H. et al. (Oct 2013). "The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia.". Am J Surg Pathol 37 (10): 1469-89. doi:10.1097/PAS.0b013e318299f2d1. PMID 24025519.
  5. ↑ 5.0 5.1 URL: https://www.auanet.org/education/modules/pathology/kidney-carcinomas/acquired-cystic.cfm. Accessed on: 13 May 2015.
  6. ↑ 6.0 6.1 6.2 6.3 Amin, Mahul B.; Eble, John; Grignon, David; Srigley, John. (2013). Urological Pathology (1st ed.). Wolters Kluwer. pp. 113. ISBN 978-0781782814.
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