Renal cell carcinoma with rhabdoid morphology

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Renal cell carcinoma with rhabdoid morphology is an uncommon finding with a poor prognosis. It is also known as renal cell carcinoma with rhabdoid change.

Micrograph showing rhabdoid change in a renal cell carcinoma. H&E stain.

It should not be confused with renal rhabdoid tumour.

General

Microscopic

Features:

  • Rhabdoid cells:
    • Eccentrically placed large round nuclei with abundant eosinophilic cytoplasm.
    • +/-Very prominent nucleolus.

Notes:

  • May be multinucleated.

Images

IHC

Features:[2]

  • Vimentin +ve (23 of 23 cases).
  • NSE +ve (~80% of cases).
  • S-100 -ve/+ve (+ve ~ 40% of cases).
  • Desmin -ve (23 of 23 cases).
  • SMA -ve (~5% of cases).

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MASS, RIGHT KIDNEY, RADICAL NEPHRECTOMY:
- CLEAR CELL RENAL CELL CARCINOMA, ISUP NUCLEOLAR GRADE 4, pT1b, pNX.
-- RHABDOID CHANGE PRESENT, SEE COMMENT.
-- MARGINS NEGATIVE FOR MALIGNANCY.
-- PLEASE SEE TUMOUR SUMMARY.

COMMENT:
Rhabdoid change is considered by some to be analogous to sarcomatoid 
change.[1]  The rhabdoid change in this case represents approximately 
35% of the tumour, and has ISUP nucleolar grade 4 nuclear features.

1. Ann Diagn Pathol. 2011 Oct;15(5):333-7.

See also

References

  1. Chapman-Fredricks, JR.; Herrera, L.; Bracho, J.; Gomez-Fernandez, C.; Leveillee, R.; Rey, L.; Jorda, M. (Oct 2011). "Adult renal cell carcinoma with rhabdoid morphology represents a neoplastic dedifferentiation analogous to sarcomatoid carcinoma.". Ann Diagn Pathol 15 (5): 333-7. doi:10.1016/j.anndiagpath.2011.03.002. PMID 21665507.
  2. Gökden, N.; Nappi, O.; Swanson, PE.; Pfeifer, JD.; Vollmer, RT.; Wick, MR.; Humphrey, PA. (Oct 2000). "Renal cell carcinoma with rhabdoid features.". Am J Surg Pathol 24 (10): 1329-38. PMID 11023094.