Difference between revisions of "Benign clear cell clusters of the kidney"
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| Caption = Benign clear cell clusters of the kidney. [[H&E stain]]. | | Caption = Benign clear cell clusters of the kidney. [[H&E stain]]. | ||
| Synonyms = | | Synonyms = | ||
| Micro = | | Micro = large cells in "small" nests with voluminous clear cytoplasm and small nuclei without prominent nucleoli | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[chromophobe renal cell carcinoma]], other [[clear cell tumours]] | | LMDDx = [[chromophobe renal cell carcinoma]], other [[clear cell tumours]] | ||
| Stains = | | Stains = | ||
| IHC = PAX8 +ve, CK7 +ve, AMACR -ve, CD68 -ve, CD10 +ve/-ve, CD117 +ve/-ve | | IHC = PAX8 +ve, CK7 +ve, AMACR -ve, CD68 -ve, CD10 +ve/-ve, CD117 +ve/-ve, vimentin -ve, CA9 -ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
| Line 31: | Line 31: | ||
| Tx = | | Tx = | ||
}} | }} | ||
'''Benign clear cell clusters of the kidney''' are a rare finding that may be confused for [[renal cell carcinoma]]<ref name=pmid33447899>{{cite journal | | '''Benign clear cell clusters of the kidney''' are a rare finding that may be confused for [[renal cell carcinoma]]<ref name=pmid33447899>{{cite journal |authors=Ortiz-Rey JA, Fachal C, Juaneda-Magdalena L, Muñoz-Martín M, Repáraz-Andrade A, Teijeira S, Lamas-Barreiro JM, Almuster-Domínguez S, San Miguel-Fraile P, Gómez-de María C |title=Clear cell clusters in the kidney: a rare finding that should not be misdiagnosed as renal cell carcinoma |journal=Virchows Arch |volume= |issue= |pages= |date=January 2021 |pmid=33447899 |doi=10.1007/s00428-021-03018-4 |url=}}</ref> or may represent a precursor lesion of renal cell carcinoma.<ref>Ross J, He H, Lin X, Yang X, "Clear cell cluster in the kidney: Is this a precursor lesion of renal cell carcinoma?", USCAP Annual Meeting 2018, Abstrct ID# 1058.</ref> | ||
==General== | ==General== | ||
*Associated with chronic renal | *Associated with [[chronic renal failure|chronic renal insufficiency]]. | ||
==Microscopic== | ==Microscopic== | ||
| Line 40: | Line 40: | ||
*Large cells predominantly in "small" nests with: | *Large cells predominantly in "small" nests with: | ||
**Voluminous clear cytoplasm. | **Voluminous clear cytoplasm. | ||
**Small nuclei without prominent nucleoli. | **Small nuclei without prominent nucleoli ([[ISUP nucleolar grade]] 1 or 2). | ||
Notes: | Notes: | ||
*Tubules with narrow lumens may be present. | *Tubules with narrow lumens may be present. | ||
*"Small": typically less than 1.5 mm. | *"Small" nests: typically less than 1.5 mm. | ||
DDx: | DDx: | ||
*[[Chromophobe renal cell carcinoma]]. | |||
*[[Clear cell renal cell carcinoma]]. | *[[Clear cell renal cell carcinoma]]. | ||
*Other [[clear cell tumours]]. | *Other [[clear cell tumours]]. | ||
===Images=== | |||
<gallery> | |||
Image: Benign clear cell clusters in the kidney -- very low mag.jpg | BCCC - very low mag. (WC) | |||
Image: Benign clear cell clusters in the kidney -- low mag.jpg | BCCC - low mag. (WC) | |||
Image: Benign clear cell clusters in the kidney -- intermed mag.jpg | BCCC - intermed. mag. (WC) | |||
Image: Benign clear cell clusters in the kidney - alt -- intermed mag.jpg | BCCC - intermed. mag. (WC) | |||
Image: Benign clear cell clusters in the kidney -- high mag.jpg | BCCC - high mag. (WC) | |||
Image: Benign clear cell clusters in the kidney - alt -- high mag.jpg | BCCC - high mag. (WC) | |||
Image: Benign clear cell clusters in the kidney -- very high mag.jpg | BCCC - very high mag. (WC) | |||
</gallery> | |||
==IHC== | ==IHC== | ||
Features:<ref name=pmid33447899/> | Features:<ref name=pmid33447899/> | ||
*PAX8 +ve. | *[[PAX8]] +ve. | ||
*AE1/AE3 +ve. | *AE1/AE3 +ve. | ||
*CK7 +ve. | *[[CK7]] +ve. | ||
*EMA +ve. | *EMA +ve. | ||
*CD10 typically focal. | *CD10 typically focal. | ||
* | |||
Others:<ref name=pmid33447899/> | |||
*[[CA9]] -ve. | |||
*vimentin -ve. | *vimentin -ve. | ||
*AMACR -ve. | *AMACR -ve. | ||
| Line 66: | Line 79: | ||
*Melan A -ve. | *Melan A -ve. | ||
*HMB-45 -ve. | *HMB-45 -ve. | ||
==See also== | ==See also== | ||
Latest revision as of 17:21, 25 March 2021
| Benign clear cell clusters of the kidney | |
|---|---|
| Diagnosis in short | |
 Benign clear cell clusters of the kidney. H&E stain. | |
|
| |
| LM | large cells in "small" nests with voluminous clear cytoplasm and small nuclei without prominent nucleoli |
| LM DDx | chromophobe renal cell carcinoma, other clear cell tumours |
| IHC | PAX8 +ve, CK7 +ve, AMACR -ve, CD68 -ve, CD10 +ve/-ve, CD117 +ve/-ve, vimentin -ve, CA9 -ve |
| Site | kidney - see kidney tumours |
|
| |
| Clinical history | chronic renal insufficiency |
| Prevalence | very rare |
| Radiology | +/-renal mass |
| Prognosis | presumed benign based on limited data/unknown |
Benign clear cell clusters of the kidney are a rare finding that may be confused for renal cell carcinoma[1] or may represent a precursor lesion of renal cell carcinoma.[2]
General
- Associated with chronic renal insufficiency.
Microscopic
Features:
- Large cells predominantly in "small" nests with:
- Voluminous clear cytoplasm.
- Small nuclei without prominent nucleoli (ISUP nucleolar grade 1 or 2).
Notes:
- Tubules with narrow lumens may be present.
- "Small" nests: typically less than 1.5 mm.
DDx:
Images
BCCC - very low mag. (WC)
BCCC - low mag. (WC)
BCCC - intermed. mag. (WC)
BCCC - intermed. mag. (WC)
BCCC - high mag. (WC)
BCCC - high mag. (WC)
BCCC - very high mag. (WC)
IHC
Features:[1]
Others:[1]
- CA9 -ve.
- vimentin -ve.
- AMACR -ve.
- CD68 -ve.
- Alpha-inhibin -ve.
- Calretinin -ve.
- Melan A -ve.
- HMB-45 -ve.
See also
References
- ↑ 1.0 1.1 1.2 Ortiz-Rey JA, Fachal C, Juaneda-Magdalena L, Muñoz-Martín M, Repáraz-Andrade A, Teijeira S, Lamas-Barreiro JM, Almuster-Domínguez S, San Miguel-Fraile P, Gómez-de María C (January 2021). "Clear cell clusters in the kidney: a rare finding that should not be misdiagnosed as renal cell carcinoma". Virchows Arch. doi:10.1007/s00428-021-03018-4. PMID 33447899.
- ↑ Ross J, He H, Lin X, Yang X, "Clear cell cluster in the kidney: Is this a precursor lesion of renal cell carcinoma?", USCAP Annual Meeting 2018, Abstrct ID# 1058.