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

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==Microscopic==
==Microscopic==
Features:
Features:
*Tubular structures with cribriforming/a sieve-like architecture.<ref>{{Cite journal  | last1 = Srigley | first1 = JR. | last2 = Delahunt | first2 = B. | last3 = Eble | first3 = JN. | last4 = Egevad | first4 = L. | last5 = Epstein | first5 = JI. | last6 = Grignon | first6 = D. | last7 = Hes | first7 = O. | last8 = Moch | first8 = H. | last9 = Montironi | first9 = R. | title = The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia. | journal = Am J Surg Pathol | volume = 37 | issue = 10 | pages = 1469-89 | month = Oct | year = 2013 | doi = 10.1097/PAS.0b013e318299f2d1 | PMID = 24025519 }}
*Fused tubular structures/cribriforming/sieve-like architecture.<ref>{{Cite journal  | last1 = Srigley | first1 = JR. | last2 = Delahunt | first2 = B. | last3 = Eble | first3 = JN. | last4 = Egevad | first4 = L. | last5 = Epstein | first5 = JI. | last6 = Grignon | first6 = D. | last7 = Hes | first7 = O. | last8 = Moch | first8 = H. | last9 = Montironi | first9 = R. | title = The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia. | journal = Am J Surg Pathol | volume = 37 | issue = 10 | pages = 1469-89 | month = Oct | year = 2013 | doi = 10.1097/PAS.0b013e318299f2d1 | PMID = 24025519 }}
</ref>
</ref>
**[[Hobnail]] cells.
**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.
*Oxylate crystals - '''important'''.
*Oxylate crystals - '''important'''.
**Look somewhat like cholesterol clefts.
**Look somewhat like cholesterol clefts.
**Seen easily in [[polarized light]].
**Seen easily in [[polarized light]].
*[[Acquired cystic disease]] in background - required.
**Changes of [[end-stage kidney]] (obsolete glomeruli, thyroidization, interstitial fibrosis).


DDx:
DDx:

Revision as of 03:41, 27 April 2016

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), oxylate crystals - seen best in polarized light
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 end-stage renal disease
Prevalence rare

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

General

Gross

  • Cysts.

Microscopic

Features:

  • Fused tubular structures/cribriforming/sieve-like architecture.[2]
    • Focal papillary architecture - common.[3]
    • Tumour cells have prominent nucleoli (ISUP nucleolar grade 3) and eosinophilic cytoplasm.
  • Oxylate crystals - important.
  • Acquired cystic disease in background - required.
    • Changes of end-stage kidney (obsolete glomeruli, thyroidization, interstitial fibrosis).

DDx:

Images

Case

www

IHC

Features:[1]

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

Others:[1]

  • CD68 -ve.
  • PAX2 -ve.
  • EMA -ve.[5]
  • HMWCK -ve.[5]
  • Vimentin +ve/-ve.[5]
  • CAM5.2 +ve/-ve.[5]

See also

References

  1. 1.0 1.1 1.2 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.
  2. 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.
  3. 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. 4.0 4.1 URL: https://www.auanet.org/education/modules/pathology/kidney-carcinomas/acquired-cystic.cfm. Accessed on: 13 May 2015.
  5. 5.0 5.1 5.2 5.3 Amin, Mahul B.; Eble, John; Grignon, David; Srigley, John. (2013). Urological Pathology (1st ed.). Wolters Kluwer. pp. 113. ISBN 978-0781782814.