Renal hybrid oncocytic/chromophobe tumour
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Renal hybrid oncocytic/chromophobe tumour, also hybrid oncocytic/chromophobe tumour (abbreviated HOCT) and hybrid tumour, is a rare kidney tumour with features of chromophobe renal cell carcinoma and renal oncocytoma.[1]
| Renal hybrid oncocytic/chromophobe tumour | |
|---|---|
| Diagnosis in short | |
 Hybrid oncocytic/chromophobe tumour of the kidney. H&E stain. | |
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| Synonyms | hybrid tumour |
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| LM | features of renal oncocytoma and chromophobe renal cell carcinoma |
| LM DDx | renal oncocytoma, chromophobe renal cell carcinoma, renal cell carcinoma, unclassified, SDH-deficient renal cell carcinoma, other renal tumours with eosinophilic cytoplasm |
| Stains | Hale's colloidal iron +ve |
| IHC | CD117 +ve, CK7 +ve (variable) |
| Molecular | no features of ChRCC |
| Grossing notes | partial nephrectomy grossing, total nephrectomy for tumour grossing |
| Site | kidney - see kidney tumours |
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| Syndromes | Birt–Hogg–Dubé syndrome |
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| Clinical history | renal mass |
| Prevalence | very rare |
| Prognosis | good on very limited data |
| Treatment | surgical excision |
General
- Rare.
- Molecular heterogeneous group[1] - may represent several different entities.
- Prognosis good - based on one series of 11 cases.[2]
May be seen in several contexts:[1]
- Sporadic.
- Birt–Hogg–Dubé syndrome.
- Renal oncocytosis.
Microscopic
Three morphologic patterns as per Hes et al.:[1]
- Renal oncocytoma and chromophobe renal cell carcinoma collision tumour.
- Different fields viewed in isolation would be compatible with the different diagnoses. Tumour component do not intermingle.
- Renal oncocytoma with scattered chromophobe cells.
- Large eosinophilic cell with intracytoplasmic vacuoles.
- Prominent nucleoli (ISUP nucleolar grade 3).
- Perinuclear halos (occasional).
- Nested architecture.
DDx:
- Renal oncocytoma - may have limited chromophobe-like areas (<=5% of tumour).[3]
- Chromophobe renal cell carcinoma, eosinophilic variant.
- SDH-deficient renal cell carcinoma (evolving entity) - lower nuclear grade, not nested.
- Other renal tumours with eosinophilic cytoplasm.
- Renal cell carcinoma, unclassified.
Images
HOCT - low mag.
HOCT - intermed. mag.
HOCT - high mag.
Stains
Features:[2]
- Hale's colloidal iron +ve (apical pattern).
IHC
Features:
Others:
- Vimentin -ve.
- EMA +ve.
- CD10 +ve.
- PAX8 +ve.
Molecular
- No features characteristic of chromophobe RCC on array-CGH analysis.[2]
See also
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Hes, O.; Petersson, F.; Kuroda, N.; Hora, M.; Michal, M. (Oct 2013). "Renal hybrid oncocytic/chromophobe tumors - a review.". Histol Histopathol 28 (10): 1257-64. PMID 23740406.
- ↑ 2.0 2.1 2.2 2.3 Poté, N.; Vieillefond, A.; Couturier, J.; Arrufat, S.; Metzger, I.; Delongchamps, NB.; Camparo, P.; Mège-Lechevallier, F. et al. (Jun 2013). "Hybrid oncocytic/chromophobe renal cell tumours do not display genomic features of chromophobe renal cell carcinomas.". Virchows Arch 462 (6): 633-8. doi:10.1007/s00428-013-1422-4. PMID 23708994.
- ↑ Trpkov, K.; Yilmaz, A.; Uzer, D.; Dishongh, KM.; Quick, CM.; Bismar, TA.; Gokden, N. (Dec 2010). "Renal oncocytoma revisited: a clinicopathological study of 109 cases with emphasis on problematic diagnostic features.". Histopathology 57 (6): 893-906. doi:10.1111/j.1365-2559.2010.03726.x. PMID 21166703.