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'''Papillary renal neoplasm with reverse polarity''' is a rare [[renal tumour]] and evolving entity.<ref name=pmid31135486>{{cite journal |authors=Al-Obaidy KI, Eble JN, Cheng L, Williamson SR, Sakr WA, Gupta N, Idrees MT, Grignon DJ |title=Papillary Renal Neoplasm With Reverse Polarity: A Morphologic, Immunohistochemical, and Molecular Study |journal=Am J Surg Pathol |volume=43 |issue=8 |pages=1099–1111 |date=August 2019 |pmid=31135486 |doi=10.1097/PAS.0000000000001288 |url=}}</ref> | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = | |||
| Width = | |||
| Caption = | |||
| Synonyms = | |||
| Micro = papillary structures, eosinophilic cytoplasm, reverse polarity of nuclei (nuclei at luminal aspect of cell), low nuclear grade | |||
| Subtypes = | |||
| LMDDx = eosinophilic [[papillary renal cell carcinoma]], other [[renal tumours with eosinophilic cytoplasm]] | |||
| Stains = | |||
| IHC = GATA3 +ve, PAX-8 +ve, CK7 +ve, CD10 +ve, CD117 -ve | |||
| EM = | |||
| Molecular = [[KRAS]] mutations | |||
| IF = | |||
| Gross = | |||
| Grossing = [[partial nephrectomy]], [[radical nephrectomy]] | |||
| Staging = | |||
| Site = [[kidney]] - see ''[[kidney tumours]]'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = rare | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = indolent - based on limited data | |||
| Other = | |||
| ClinDDx = other [[kidney tumours]] | |||
| Tx = | |||
}} | |||
'''Papillary renal neoplasm with reverse polarity''' is a rare [[renal tumour]] and an evolving entity.<ref name=pmid31135486>{{cite journal |authors=Al-Obaidy KI, Eble JN, Cheng L, Williamson SR, Sakr WA, Gupta N, Idrees MT, Grignon DJ |title=Papillary Renal Neoplasm With Reverse Polarity: A Morphologic, Immunohistochemical, and Molecular Study |journal=Am J Surg Pathol |volume=43 |issue=8 |pages=1099–1111 |date=August 2019 |pmid=31135486 |doi=10.1097/PAS.0000000000001288 |url=}}</ref> It has a distinctive morphology that matches the name. | |||
==General== | ==General== | ||
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DDx: | DDx: | ||
*Eosinophilic [[papillary renal cell carcinoma]] - considered distinct from this entity. | |||
*[[Renal tumours with eosinophilic cytoplasm]]. | *[[Renal tumours with eosinophilic cytoplasm]]. | ||
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<pre> | <pre> | ||
A. Right Kidney, Tumour, Partial Nephrectomy: | A. Right Kidney, Tumour, Partial Nephrectomy: | ||
- Papillary renal neoplasm with reverse polarity, see comment. | - Papillary renal neoplasm with reverse polarity, clear of margin, see comment. | ||
Comment: | Comment: | ||
The tumour has a papillary architecture, eosinophilic cytoplasm and reversed nuclear polarity. | The tumour has a papillary architecture, eosinophilic cytoplasm, low nuclear grade, and reversed nuclear polarity. | ||
It stains as follows: | It stains as follows: | ||
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NEGATIVE: vimentin (stroma), CD117, CD10. | NEGATIVE: vimentin (stroma), CD117, CD10. | ||
The findings are in keeping with papillary renal neoplasm with reverse polarity (PRNRP). PRNRP is thought to be distinct from papillary RCC.[1][2] Limited data suggests PRNRP has an indolent behaviour.[3] Follow-up is recommended. | |||
1. Pathol Int. 2024 Apr;74(4):222-226. doi: 10.1111/pin.13417. | 1. Pathol Int. 2024 Apr;74(4):222-226. doi: 10.1111/pin.13417. https://pubmed.ncbi.nlm.nih.gov/38456605/ | ||
2. Hum Pathol. 2023 Dec:142:1-6. doi: 10.1016/j.humpath.2023.09.011. | 2. Hum Pathol. 2023 Dec:142:1-6. doi: 10.1016/j.humpath.2023.09.011. https://pubmed.ncbi.nlm.nih.gov/37797754/ | ||
3. Am J Surg Pathol. 2019 Aug;43(8):1099-1111. doi: 10.1097/PAS.0000000000001288. | 3. Am J Surg Pathol. 2019 Aug;43(8):1099-1111. doi: 10.1097/PAS.0000000000001288. https://pubmed.ncbi.nlm.nih.gov/31135486/ | ||
</pre> | </pre> | ||
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