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Difference between revisions of "Kidney tumours"
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→Chromophobe renal cell carcinoma: more
m (→Angiomyolipoma) |
m (→Chromophobe renal cell carcinoma: more) |
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==Chromophobe renal cell carcinoma== | ==Chromophobe renal cell carcinoma== | ||
* | *Abbreviated ''ChRCC''. | ||
===General=== | ===General=== | ||
*Least common of the common types of RCC. | |||
*''Fuhrman grading'' for this entity is controversial, as it does not appear to have any predictive value.<ref name=pmid17527087></ref> | |||
There are two subtypes:<ref name=Ref_GUP293>{{Ref GUP|293}}</ref> | There are two subtypes:<ref name=Ref_GUP293>{{Ref GUP|293}}</ref> | ||
*Classic. | *Classic. | ||
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===Microscopic=== | ===Microscopic=== | ||
====Classic==== | |||
Features - classic type:<ref>{{Ref PBoD|1016-7}}</ref><ref name=Ref_GUP293>{{Ref GUP|293}}</ref>, 3 P's [[mnemonic]]: | Features - classic type:<ref>{{Ref PBoD|1016-7}}</ref><ref name=Ref_GUP293>{{Ref GUP|293}}</ref>, 3 P's [[mnemonic]]: | ||
*Pale cytoplasm, with wisps of eosinophilic material; the cells are not completely clear, they have "cobwebs". | *Pale cytoplasm, with wisps of eosinophilic material; the cells are not completely clear, they have "cobwebs". | ||
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*Periphery of cell distinct, i.e. cell membrane is easy to discern. | *Periphery of cell distinct, i.e. cell membrane is easy to discern. | ||
Notes: | |||
*May have [[psammoma bodies]]. | |||
====Eosinophilic variant==== | |||
Features - eosinophilic variant:<ref name=Ref_GUP293>{{Ref GUP|293}}</ref> | Features - eosinophilic variant:<ref name=Ref_GUP293>{{Ref GUP|293}}</ref> | ||
*Eosinophilic (finely granular) cytoplasm. | *'''Eosinophilic''' (finely granular) cytoplasm. | ||
*Perinuclear clearing - '''key feature'''. | *Perinuclear clearing - '''key feature'''. | ||
*Periphery of cell distinct. | *Periphery of cell distinct. | ||
*Smaller cells than classic subtype. | *'''Smaller cells''' than classic subtype. | ||
Notes: | Notes: | ||
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#**No perinuclear clearing in oncocytoma. | #**No perinuclear clearing in oncocytoma. | ||
Image: [http://commons.wikimedia.org/wiki/File:Oncocytic_chromophobe_rcc_high_mag.jpg Oncocytic chromophobe RCC (WC)]. | Image: | ||
*[http://commons.wikimedia.org/wiki/File:Oncocytic_chromophobe_rcc_high_mag.jpg Oncocytic chromophobe RCC (WC)]. | |||
===IHC=== | ===IHC=== | ||
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DDx: | DDx: | ||
*May appear similar to | *May appear similar to [[renal oncocytoma|oncocytoma]] -- particularily the eosinophilic variant. | ||
**IHC may be useful to differentiate (CK7: oncocytoma = cytoplasm +ve, chromophobe = cell membrane +ve). | **IHC may be useful to differentiate (CK7: oncocytoma = cytoplasm +ve, chromophobe = cell membrane +ve). | ||
*Classic ChRCC may be challenging to differentiate from clear cell RCC. | *Classic ChRCC may be challenging to differentiate from clear cell RCC. | ||
**Perinuclear clearing is ''not'' seen in clear cell RCC. | **Perinuclear clearing is ''not'' seen in clear cell RCC. | ||
**ChRCC has wisps in the cytoplasm | **ChRCC has wisps in the cytoplasm. | ||
=Renal translocation carcinomas= | =Renal translocation carcinomas= | ||