Difference between revisions of "Kidney tumours"

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Kidney tumours (view source)

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=Renal translocation carcinomas=
=Renal translocation carcinomas=
==Renal tumour with Xp11.2 translocation==
==Renal tumour with Xp11.2 translocation==
===General===
{{Main|Renal tumour with Xp11.2 translocation}}
*Defined by the presence of a fusion gene formed with TFE3 @ Xp11.2.
*TFE3 is the gene involved in the translocation seen in [[alveolar soft part sarcoma]] (ASPS).
*Poor prognosis ~ 50% present at stage IV, majority of lymph node metastases.
*~1/3 of childhood RCC.<ref name=pmid17667536>{{Cite journal  | last1 = Argani | first1 = P. | last2 = Olgac | first2 = S. | last3 = Tickoo | first3 = SK. | last4 = Goldfischer | first4 = M. | last5 = Moch | first5 = H. | last6 = Chan | first6 = DY. | last7 = Eble | first7 = JN. | last8 = Bonsib | first8 = SM. | last9 = Jimeno | first9 = M. | title = Xp11 translocation renal cell carcinoma in adults: expanded clinical, pathologic, and genetic spectrum. | journal = Am J Surg Pathol | volume = 31 | issue = 8 | pages = 1149-60 | month = Aug | year = 2007 | doi = 10.1097/PAS.0b013e318031ffff | PMID = 17667536 }}</ref>
 
===Microscopic===
Features:<ref name=Ref_WMSP285>{{Ref WMSP|285}}</ref>
*Large cells.
*Clear or eosinophilic cytoplasm.
*Papillae or nests.
*[[Psammoma bodies]] - common.<ref name=pmid17102051>{{Cite journal  | last1 = Prasad | first1 = SR. | last2 = Humphrey | first2 = PA. | last3 = Catena | first3 = JR. | last4 = Narra | first4 = VR. | last5 = Srigley | first5 = JR. | last6 = Cortez | first6 = AD. | last7 = Dalrymple | first7 = NC. | last8 = Chintapalli | first8 = KN. | title = Common and uncommon histologic subtypes of renal cell carcinoma: imaging spectrum with pathologic correlation. | journal = Radiographics | volume = 26 | issue = 6 | pages = 1795-806; discussion 1806-10 | month =  | year =  | doi = 10.1148/rg.266065010 | PMID = 17102051 }}</ref>
**Calcification is considered the '''classic histomorphologic feature'''.
*[[Hyaline bodies]] - common.
 
Notes:
*Looks clear cell RCC ''or'' papillary RCC ''or'' a hybrid between the two.
*May resemble [[alveolar soft part sarcoma]].
 
DDx:
*[[Clear cell RCC]].
*[[Papillary RCC]].
*[[Epithelioid angiomyolipoma]].
*[[Clear cell papillary renal cell carcinoma]].
 
====Images====
<gallery>
Image:Xp11.2_translocation_renal_cell_carcinoma_-_intermed_mag.jpg | Xp11.2 translocation RCC - intermed. mag. (WC/Nephron)
Image:Xp11.2_translocation_renal_cell_carcinoma_-_high_mag.jpg | Xp11.2 translocation RCC - high mag. (WC/Nephron)
</gallery>
www:
*[http://www.flickr.com/photos/40764007@N08/7403237732/in/photostream/ Translocation carcinoma (flickr.com)].
 
===IHC===
*TFE3 +ve (nucleus) - '''key feature'''.<ref name=Ref_WMSP285>{{Ref WMSP|285}}</ref>
*CD10 +ve.
*Vimentin +ve.
*CK7 -ve.
**Positive in ~20% of cases.<ref name=pmid21804394>{{Cite journal  | last1 = He | first1 = H. | last2 = Zhou | first2 = GX. | last3 = Zhou | first3 = M. | last4 = Chen | first4 = L. | title = The distinction of clear cell carcinoma of the female genital tract, clear cell renal cell carcinoma, and translocation-associated renal cell carcinoma: an immunohistochemical study using tissue microarray. | journal = Int J Gynecol Pathol | volume = 30 | issue = 5 | pages = 425-30 | month = Sep | year = 2011 | doi = 10.1097/PGP.0b013e318214dd4f | PMID = 21804394 }}</ref>
 
Others:
*HMB-45 & Melan A -ve.
**Positive in ''epithelioid [[angiomyolipoma]]''.
 
===Molecular===
*[[Translocation]] involving TFE3, e.g. t(X;1)(p11.2;q21).<ref name=Ref_WMSP285>{{Ref WMSP|285}}</ref>


==Renal tumour with t(6;11) translocation==
==Renal tumour with t(6;11) translocation==
Michael
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