Clear cell renal cell carcinoma: Difference between revisions
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| Micro = solid or [[trabecular]] pattern, polygonal cells usually with clear cytoplasm (may be eosinophilic - esp. in high grade tumours), central nucleus, delicate branching vasculature (chicken wire-like), +/-hyaline bodies | | Micro = solid or [[trabecular]] pattern, polygonal cells usually with clear cytoplasm (may be eosinophilic - esp. in high grade tumours), central nucleus, delicate branching vasculature (chicken wire-like), +/-hyaline bodies | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[chromophobe renal cell carcinoma]], [[clear cell papillary renal cell tumour]], [[Xp11.2 translocation carcinoma]], [[ELOC-mutated renal cell carcinoma]], [[renal cell carcinoma with fibromyomatous stroma]], [[benign clear cell clusters of the kidney]], [[alveolar soft part sarcoma]], [[adrenocortical carcinoma]] | | LMDDx = [[chromophobe renal cell carcinoma]], [[clear cell papillary renal cell tumour]], [[Xp11.2 translocation carcinoma]], [[ELOC-mutated renal cell carcinoma]], [[renal cell carcinoma with fibromyomatous stroma]], [[benign clear cell clusters of the kidney]], [[alveolar soft part sarcoma]], [[adrenocortical carcinoma]], [[hemangioblastoma of the kidney]] | ||
| Stains = PAS +ve, PAS-D -ve, [[Hale's colloidal iron stain]] -ve | | Stains = PAS +ve, PAS-D -ve, [[Hale's colloidal iron stain]] -ve | ||
| IHC = [[CA9]] +ve, CK7 -ve, CK20 -ve, TFE3 -ve, PAX8 +ve, vimentin +ve | | IHC = [[CA9]] +ve, CK7 -ve, CK20 -ve, TFE3 -ve, PAX8 +ve, vimentin +ve | ||
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*[[Benign clear cell clusters of the kidney]]. | *[[Benign clear cell clusters of the kidney]]. | ||
*[[Renal cell carcinoma with fibromyomatous stroma]]. | *[[Renal cell carcinoma with fibromyomatous stroma]]. | ||
*[[Hemangioblastoma of the kidney]] - especially in [[von Hippel-Lindau disease]]. | |||
**S-100 +ve, inhibin +ve, PAX-8+ve, EMA -ve, CA9 -ve. | |||
===Images=== | ===Images=== | ||
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==IHC== | ==IHC== | ||
*CAIX (also CA9) +ve (47/59 cases ~ 94%).<ref name=pmid36340463>{{cite journal |authors=Yousef A, Kim SS, Krizova A |title=CAIX Immunostaining in Non-neoplastic Renal Diseases |journal=Cancer Diagn Progn |volume=2 |issue=6 |pages=661–667 |date=2022 |pmid=36340463 |pmc=9628162 |doi=10.21873/cdp.10157 |url=}}</ref> | |||
*CD10 +ve. | *CD10 +ve. | ||
*Vimentin +ve. | *Vimentin +ve. | ||
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*Glut-1 >85% of CCRCC (membranous pattern).<ref name=pmid17638658>{{Cite journal | last1 = Ozcan | first1 = A. | last2 = Shen | first2 = SS. | last3 = Zhai | first3 = QJ. | last4 = Truong | first4 = LD. | title = Expression of GLUT1 in primary renal tumors: morphologic and biologic implications. | journal = Am J Clin Pathol | volume = 128 | issue = 2 | pages = 245-54 | month = Aug | year = 2007 | doi = 10.1309/HV6NJVRQKK4QHM9F | PMID = 17638658 }}</ref> | *Glut-1 >85% of CCRCC (membranous pattern).<ref name=pmid17638658>{{Cite journal | last1 = Ozcan | first1 = A. | last2 = Shen | first2 = SS. | last3 = Zhai | first3 = QJ. | last4 = Truong | first4 = LD. | title = Expression of GLUT1 in primary renal tumors: morphologic and biologic implications. | journal = Am J Clin Pathol | volume = 128 | issue = 2 | pages = 245-54 | month = Aug | year = 2007 | doi = 10.1309/HV6NJVRQKK4QHM9F | PMID = 17638658 }}</ref> | ||
*E-cadherin +ve - usually weak, often -ve in higher stage tumours.<ref name=pmid23939157>{{Cite journal | last1 = Hu | first1 = H. | last2 = Chen | first2 = JW. | last3 = Xu | first3 = KX. | last4 = Wang | first4 = D. | last5 = Wang | first5 = Y. | last6 = Wang | first6 = GW. | last7 = Zhang | first7 = SY. | last8 = Wang | first8 = XF. | title = [Expressions of CMTM8 and E-cadherin in primary and metastatic clear cell renal cell carcinoma]. | journal = Beijing Da Xue Xue Bao | volume = 45 | issue = 4 | pages = 537-41 | month = Aug | year = 2013 | doi = | PMID = 23939157 }}</ref> | *E-cadherin +ve - usually weak, often -ve in higher stage tumours.<ref name=pmid23939157>{{Cite journal | last1 = Hu | first1 = H. | last2 = Chen | first2 = JW. | last3 = Xu | first3 = KX. | last4 = Wang | first4 = D. | last5 = Wang | first5 = Y. | last6 = Wang | first6 = GW. | last7 = Zhang | first7 = SY. | last8 = Wang | first8 = XF. | title = [Expressions of CMTM8 and E-cadherin in primary and metastatic clear cell renal cell carcinoma]. | journal = Beijing Da Xue Xue Bao | volume = 45 | issue = 4 | pages = 537-41 | month = Aug | year = 2013 | doi = | PMID = 23939157 }}</ref> | ||
A panel to confirm the diagnosis: | A panel to confirm the diagnosis: | ||
*CK7 (-ve), CD10 (+ve), PAX8 (+ve), vimentin (+ve). | *CAIX (+ve), CK7 (-ve), CD10 (+ve), PAX8 (+ve), vimentin (+ve). | ||
===CCRCC versus [[chromophobe RCC]]=== | ===CCRCC versus [[chromophobe RCC]]=== | ||