Benign clear cell clusters of the kidney

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Benign clear cell clusters of the kidney are a rare finding that may be confused for renal cell carcinoma[1] or may represent a precursor lesion of renal cell carcinoma.[2]

Benign clear cell clusters of the kidney
Diagnosis in short

Benign clear cell clusters of the kidney. H&E stain.
LM large cells in "small" nests with voluminous clear cytoplasm and small nuclei without prominent nucleoli
LM DDx chromophobe renal cell carcinoma, other clear cell tumours
IHC PAX8 +ve, CK7 +ve, AMACR -ve, CD68 -ve, CD10 +ve/-ve, CD117 +ve/-ve, vimentin -ve, CA9 -ve
Site kidney - see kidney tumours
Clinical history chronic renal insufficiency
Prevalence very rare
Radiology +/-renal mass
Prognosis presumed benign based on limited data/unknown

General

Microscopic

Features:

  • Large cells predominantly in "small" nests with:

Notes:

  • Tubules with narrow lumens may be present.
  • "Small" nests: typically less than 1.5 mm.

DDx:

Images

  • BCCC - very low mag. (WC)

  • BCCC - low mag. (WC)

  • BCCC - intermed. mag. (WC)

  • BCCC - intermed. mag. (WC)

  • BCCC - high mag. (WC)

  • BCCC - high mag. (WC)

  • BCCC - very high mag. (WC)

IHC

Features:[1]

  • PAX8 +ve.
  • AE1/AE3 +ve.
  • CK7 +ve.
  • EMA +ve.
  • CD10 typically focal.

Others:[1]

  • CA9 -ve.
  • vimentin -ve.
  • AMACR -ve.
  • CD68 -ve.
  • Alpha-inhibin -ve.
  • Calretinin -ve.
  • Melan A -ve.
  • HMB-45 -ve.

See also

References

  1. ↑ 1.0 1.1 1.2 Ortiz-Rey JA, Fachal C, Juaneda-Magdalena L, Muñoz-Martín M, Repáraz-Andrade A, Teijeira S, Lamas-Barreiro JM, Almuster-Domínguez S, San Miguel-Fraile P, Gómez-de María C (January 2021). "Clear cell clusters in the kidney: a rare finding that should not be misdiagnosed as renal cell carcinoma". Virchows Arch. doi:10.1007/s00428-021-03018-4. PMID 33447899.
  2. ↑ Ross J, He H, Lin X, Yang X, "Clear cell cluster in the kidney: Is this a precursor lesion of renal cell carcinoma?", USCAP Annual Meeting 2018, Abstrct ID# 1058.
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