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Difference between revisions of "Chromophobe renal cell carcinoma"
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| Micro = pale/clear (or eosinophilic) cytoplasm with wisps of eosinophilic material, perinuclear clearing (a pale halo surrounds the nucleus), periphery of cell distinct (cell membrane is easy to discern -- plant cell-like) | | Micro = pale/clear (or eosinophilic) cytoplasm with wisps of eosinophilic material, perinuclear clearing (a pale halo surrounds the nucleus), periphery of cell distinct (cell membrane is easy to discern -- plant cell-like) | ||
| Subtypes = classic, eosinophilic variant | | Subtypes = classic, eosinophilic variant | ||
| LMDDx = [[clear cell renal cell carcinoma]] (classic), [[renal oncocytoma]], [[clear cell renal cell carcinoma]] eosinophilic variant | | LMDDx = [[clear cell renal cell carcinoma]] (classic), [[renal oncocytoma]], [[clear cell renal cell carcinoma]] eosinophilic variant, [[renal hybrid oncocytic/chromophobe tumour]], other [[renal tumours with eosinophilic cytoplasm]] | ||
| Stains = [[Hale's colloidal iron]] ([[Mueller-Mowry stain]]) +ve | | Stains = [[Hale's colloidal iron]] ([[Mueller-Mowry stain]]) +ve | ||
| IHC = CK7 +ve cell membrane, CD117 +ve, vimentin -ve | | IHC = CK7 +ve cell membrane, CD117 +ve, vimentin -ve | ||
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**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. | ||
*Other [[clear cell tumours]]. | |||
*[[Benign clear cell clusters of the kidney]] - somewhat controversial. | |||
====Images==== | ====Images==== | ||
| Line 99: | Line 101: | ||
#*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 hybrid oncocytic/chromophobe tumour]]. | |||
#Other [[renal tumours with eosinophilic cytoplasm]]. | #Other [[renal tumours with eosinophilic cytoplasm]]. | ||
====Images==== | ====Images==== | ||
| Line 131: | Line 134: | ||
==IHC== | ==IHC== | ||
*CK7 +ve cell membrane.<ref name=Ref_GUP293>{{Ref GUP|293}}</ref> | *[[CK7]] +ve cell membrane.<ref name=Ref_GUP293>{{Ref GUP|293}}</ref> | ||
**Useful for differentiating from oncocytoma. | **Useful for differentiating from oncocytoma. | ||
*CD117 +ve. | *[[CD117]] +ve. | ||
*Vimentin -ve.<ref name=pmid22455881>{{Cite journal | last1 = Zhang | first1 = W. | last2 = Yu | first2 = WJ. | last3 = Jiang | first3 = YX. | last4 = Li | first4 = YJ. | last5 = Han | first5 = F. | last6 = Liu | first6 = Y. | last7 = Han | first7 = ZL. | title = [Chromophobe renal cell carcinoma: a clinicopathologic study and immunophenotypes of 42 cases]. | journal = Zhonghua Bing Li Xue Za Zhi | volume = 41 | issue = 2 | pages = 76-80 | month = Feb | year = 2012 | doi = | PMID = 22455881 }}</ref><ref name=pmid24095630>{{Cite journal | last1 = Din | first1 = NU. | last2 = Fatima | first2 = S. | last3 = Ahmad | first3 = Z. | title = Chromophobe renal cell carcinoma: a morphologic and immunohistochemical study of 45 cases. | journal = Ann Diagn Pathol | volume = 17 | issue = 6 | pages = 508-13 | month = Dec | year = 2013 | doi = 10.1016/j.anndiagpath.2013.06.005 | PMID = 24095630 }}</ref> | *Vimentin -ve.<ref name=pmid22455881>{{Cite journal | last1 = Zhang | first1 = W. | last2 = Yu | first2 = WJ. | last3 = Jiang | first3 = YX. | last4 = Li | first4 = YJ. | last5 = Han | first5 = F. | last6 = Liu | first6 = Y. | last7 = Han | first7 = ZL. | title = [Chromophobe renal cell carcinoma: a clinicopathologic study and immunophenotypes of 42 cases]. | journal = Zhonghua Bing Li Xue Za Zhi | volume = 41 | issue = 2 | pages = 76-80 | month = Feb | year = 2012 | doi = | PMID = 22455881 }}</ref><ref name=pmid24095630>{{Cite journal | last1 = Din | first1 = NU. | last2 = Fatima | first2 = S. | last3 = Ahmad | first3 = Z. | title = Chromophobe renal cell carcinoma: a morphologic and immunohistochemical study of 45 cases. | journal = Ann Diagn Pathol | volume = 17 | issue = 6 | pages = 508-13 | month = Dec | year = 2013 | doi = 10.1016/j.anndiagpath.2013.06.005 | PMID = 24095630 }}</ref> | ||
Others:<ref name=pmid18603673>{{Cite journal | last1 = Geramizadeh | first1 = B. | last2 = Ravanshad | first2 = M. | last3 = Rahsaz | first3 = M. | title = Useful markers for differential diagnosis of oncocytoma, chromophobe renal cell carcinoma and conventional renal cell carcinoma. | journal = Indian J Pathol Microbiol | volume = 51 | issue = 2 | pages = 167-71 | month = | year = | doi = | PMID = 18603673 }}</ref> | |||
*CD10 -ve. | |||
*RCC -ve. | |||
Uncommon stains for ChRCC versus oncocytoma: | Uncommon stains for ChRCC versus oncocytoma: | ||
*PAX2 -ve .<ref name=pmid17210525>{{cite journal |author=Memeo L, Jhang J, Assaad AM, ''et al.'' |title=Immunohistochemical analysis for cytokeratin 7, KIT, and PAX2: value in the differential diagnosis of chromophobe cell carcinoma |journal=Am. J. Clin. Pathol. |volume=127 |issue=2 |pages=225–9 |year=2007 |month=February |pmid=17210525 |doi=10.1309/9KWEA4W9Y94D1AEE |url=http://ajcp.ascpjournals.org/cgi/pmidlookup?view=long&pmid=17210525}}</ref> | *PAX2 -ve .<ref name=pmid17210525>{{cite journal |author=Memeo L, Jhang J, Assaad AM, ''et al.'' |title=Immunohistochemical analysis for cytokeratin 7, KIT, and PAX2: value in the differential diagnosis of chromophobe cell carcinoma |journal=Am. J. Clin. Pathol. |volume=127 |issue=2 |pages=225–9 |year=2007 |month=February |pmid=17210525 |doi=10.1309/9KWEA4W9Y94D1AEE |url=http://ajcp.ascpjournals.org/cgi/pmidlookup?view=long&pmid=17210525}}</ref> | ||
| Line 145: | Line 152: | ||
*CD117 +ve. | *CD117 +ve. | ||
**-ve in CCRCC. | **-ve in CCRCC. | ||
* | *CA9 ([[carbonic anhydrase 9]]) -ve. | ||
**+ve (strong membranous) in CCRCC.<ref name=pmid21677535>{{cite journal |author=Al-Ahmadie HA, Alden D, Fine SW, ''et al.'' |title=Role of immunohistochemistry in the evaluation of needle core biopsies in adult renal cortical tumors: an ex vivo study |journal=Am. J. Surg. Pathol. |volume=35 |issue=7 |pages=949–61 |year=2011 |month=July |pmid=21677535 |doi=10.1097/PAS.0b013e31821e25cd |url=}}</ref> | **+ve (strong membranous) in CCRCC.<ref name=pmid21677535>{{cite journal |author=Al-Ahmadie HA, Alden D, Fine SW, ''et al.'' |title=Role of immunohistochemistry in the evaluation of needle core biopsies in adult renal cortical tumors: an ex vivo study |journal=Am. J. Surg. Pathol. |volume=35 |issue=7 |pages=949–61 |year=2011 |month=July |pmid=21677535 |doi=10.1097/PAS.0b013e31821e25cd |url=}}</ref> | ||
*CK7 +ve. | *CK7 +ve. | ||
**-ve in CCRCC. | **-ve in CCRCC. | ||
Others: | |||
*[[DOG1]] +ve (Swalchick ''et al.''<ref name=pmid26678977>{{Cite journal | last1 = Swalchick | first1 = W. | last2 = Shamekh | first2 = R. | last3 = Bui | first3 = MM. | title = Is DOG1 Immunoreactivity Specific to Gastrointestinal Stromal Tumor? | journal = Cancer Control | volume = 22 | issue = 4 | pages = 498-504 | month = Oct | year = 2015 | doi = | PMID = 26678977 }}</ref> 32 +ve of 37 cases; Zhao ''et al.''<ref name=pmid25596994>{{Cite journal | last1 = Zhao | first1 = W. | last2 = Tian | first2 = B. | last3 = Wu | first3 = C. | last4 = Peng | first4 = Y. | last5 = Wang | first5 = H. | last6 = Gu | first6 = WL. | last7 = Gao | first7 = FH. | title = DOG1, cyclin D1, CK7, CD117 and vimentin are useful immunohistochemical markers in distinguishing chromophobe renal cell carcinoma from clear cell renal cell carcinoma and renal oncocytoma. | journal = Pathol Res Pract | volume = 211 | issue = 4 | pages = 303-7 | month = Apr | year = 2015 | doi = 10.1016/j.prp.2014.12.014 | PMID = 25596994 }}</ref> 32 +ve of 32 cases). | |||
**Useful in ChRCC versus clear cell RCC. | |||
A panel: | |||
*CK7, [[PAX8]], CD117, CD10, [[Mueller-Mowry stain]]. | |||
===Comparison between some renal tumours with eosinophilic cytoplasm=== | |||
{| class="wikitable sortable" | |||
!Tumour | |||
![[CK7]] | |||
![[CD117]] | |||
![[GATA3]] | |||
|- | |||
| [[Renal oncocytoma]] | |||
| -ve † | |||
| +ve | |||
| -ve/+ve | |||
|- | |||
| Chromophobe renal cell carcinoma | |||
| +ve ‡ | |||
| +ve | |||
| -ve | |||
|- | |||
| [[Low-grade oncocytic tumour]] | |||
| +ve | |||
| -ve | |||
| +ve | |||
|- | |||
|} | |||
† may have scattered positive cells<br> | |||
‡ diffuse and strong | |||
==Molecular== | ==Molecular== | ||
| Line 159: | Line 199: | ||
*Complex plicated cell membrane. | *Complex plicated cell membrane. | ||
=== | ===Images=== | ||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111713/figure/F5/ Microvesicles in ChRCC (nih.gov)].<ref name=pmid21713152/> | *[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111713/figure/F5/ Microvesicles in ChRCC (nih.gov)].<ref name=pmid21713152/> | ||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111713/figure/F6/ Cell membrane in ChRCC (nih.gov)]. | *[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111713/figure/F6/ Cell membrane in ChRCC (nih.gov)]. | ||
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Negative: AMACR, CD10, CD68, RCC, vimentin. | Negative: AMACR, CD10, CD68, RCC, vimentin. | ||
</pre> | </pre> | ||
===Micro=== | |||
The sections show a sheeting tumour with abundant and eosinophilic cytoplasm. The tumour cell cell membranes are prominent and plant-like. Perinuclear clearing is present. Binucleation is frequent and the nuclear membranes moderately irregular. No definite papillae or macrophages are present. Nucleoli are not prominent. Small blood vessels are not prominent. | |||
====Alternate==== | |||
The sections show a tumour composed of compact nests. The cytoplasm is abundant and eosinophilic. Perinuclear clearing is prominent. Binucleation is frequent and the nuclear membranes moderately irregular to round. No definite papillae or macrophages are present. Nucleoli are not prominent. | |||
==See also== | ==See also== | ||