Low-grade oncocytic renal tumour
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| Low-grade oncocytic renal tumour | |
|---|---|
| Diagnosis in short | |
 Low-grade renal oncocytic tumour. H&E stain. | |
|
| |
| LM | abundant eosinophilic cytoplasm, nuclei uniform and round without significant pleomorphism, solid or tubular architecture |
| LM DDx | renal oncocytoma, chromophobe renal cell carcinoma eosinophilic variant, clear cell renal cell carcinoma eosinophilic variant, papillary renal cell carcinoma oncocytic variant, tubulocystic carcinoma of the kidney, other renal tumours with eosinophilic cytoplasm, benign liver |
| IHC | CK7 +ve, CD117 -ve, PAX8 +ve |
| Grossing notes | partial nephrectomy grossing, total nephrectomy for tumour grossing |
| Site | kidney - see kidney tumours |
|
| |
| Clinical history | often incidentally discovered mass |
| Prognosis | likely benign |
| Clin. DDx | other kidney tumours |
Low-grade oncocytic renal tumour, abbreviated LOT, is an unusual renal tumour that does not neatly fit into any WHO renal neoplasia category. It is also known as renal oncocytic tumour that is CD117 negative and CK7 positive.
Whether it is a distinct entity is not clear as of 2019.[1] It can be considered an emerging entity that may be in the WHO classification of renal neoplasia in the future.[2]
General
- Very rare.
- Benign behaviour based on a small series.[1]
Microscopic
Features:[3]
- Oncocytic cytoplasm.
- Round nuclei.
- Tubular or solid architecture.
- Edematous areas with loosly arranged cells.
- Low ISUP nucleolar grade - grade 1 or 2.
DDx:
- Renal oncocytoma.
- Chromophobe renal cell carcinoma.
- Renal hybrid oncocytic/chromophobe tumour.
- Renal cell carcinoma, unclassified.
- Renal tumours with eosinophilic cytoplasm.
Images
LGORT - low mag. (WC)
LGORT - intermed. mag. (WC)
LGORT - intermed. mag. (WC)
LGORT - high mag. (WC)
LGORT - high mag. (WC)
LGORT - high mag. (WC)
IHC
Features:
- CK7 +ve.
- CD117 -ve.
Others:
- CD10 -ve/+ve.
- AMACR -ve/+ve.
- CA9 -ve.
- CK20 -ve.
- CD10 -ve.
See also
References
- ↑ 1.0 1.1 Trpkov K, Williamson SR, Gao Y, Martinek P, Cheng L, Sangoi AR, Yilmaz A, Wang C, San Miguel Fraile P, Perez Montiel DM, Bulimbasić S, Rogala J, Hes O (August 2019). "Low-grade oncocytic tumour of kidney (CD117-negative, cytokeratin 7-positive): a distinct entity?". Histopathology 75 (2): 174–184. doi:10.1111/his.13865. PMID 30895640.
- ↑ Siadat F, Trpkov K (January 2020). "ESC, ALK, HOT and LOT: Three Letter Acronyms of Emerging Renal Entities Knocking on the Door of the WHO Classification". Cancers (Basel) 12 (1). doi:10.3390/cancers12010168. PMC 7017067. PMID 31936678. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017067/.
- ↑ Trpkov K, Williamson S, Martinek P, Cheng L, San Miguel Fraile P, Yilmaz A, Hes O, Oncocytic Renal Tumors with CD117 Negative, Cytokeratin 7 Positive Immunoprofile are Different from Eosinophilic Chromophobe Renal Cell Carcinoma (ChrRCC) and Oncocytoma. United States and Canadian Academy of Pathology Annual Meeting 2018.