Difference between revisions of "Eosinophilic, solid and cystic renal cell carcinoma"
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = | | Image = Eosinophilic, solid and cystic renal cell carcinoma -- low mag.jpg | ||
| Width = | | Width = | ||
| Caption = | | Caption = Eosinophilic, solid and cystic renal cell carcinoma. [[H&E stain]]. | ||
| Synonyms = | | Synonyms = | ||
| Micro = epithelioid cells with abundant stippled eosinophilic cytoplasm +/- peripheral clearing, round nuclei with prominent [[nucleoli]], nested or solid architecture +/- cystic spaces with [[hobnail]] lining cells, +/-scattered histiocytes (common), +/-multi-nucleation (common), +/-small intracytoplasmic globules | | Micro = epithelioid cells with abundant stippled eosinophilic cytoplasm +/- peripheral clearing, round nuclei with prominent [[nucleoli]], nested or solid architecture +/- cystic spaces with [[hobnail]] lining cells, +/-scattered histiocytes (common), +/-multi-nucleation (common), +/-small intracytoplasmic globules | ||
| Line 11: | Line 11: | ||
| IHC = [[PAX8]] +ve, [[CK20]] +ve, [[CK7]] -ve, CA9 -ve, CD117 -ve, HMB-45 -ve | | IHC = [[PAX8]] +ve, [[CK20]] +ve, [[CK7]] -ve, CA9 -ve, CD117 -ve, HMB-45 -ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = [[Renal neoplasms with TSC/mTOR pathway mutations|TSC/mTOR pathway mutations]] | ||
| IF = | | IF = | ||
| Gross = solid and cystic | | Gross = solid and cystic | ||
| Line 32: | Line 32: | ||
'''Eosinophilic, solid and cystic renal cell carcinoma''', abbreviated '''ESC-RCC''', is recently described, evolving [[kidney tumour]] that is presumed to be [[malignant]].<ref name=pmid26414221>{{Cite journal | last1 = Trpkov | first1 = K. | last2 = Hes | first2 = O. | last3 = Bonert | first3 = M. | last4 = Lopez | first4 = JI. | last5 = Bonsib | first5 = SM. | last6 = Nesi | first6 = G. | last7 = Comperat | first7 = E. | last8 = Sibony | first8 = M. | last9 = Berney | first9 = DM. | title = Eosinophilic, Solid, and Cystic Renal Cell Carcinoma: Clinicopathologic Study of 16 Unique, Sporadic Neoplasms Occurring in Women. | journal = Am J Surg Pathol | volume = | issue = | pages = | month = Sep | year = 2015 | doi = 10.1097/PAS.0000000000000508 | PMID = 26414221 }}</ref> | '''Eosinophilic, solid and cystic renal cell carcinoma''', abbreviated '''ESC-RCC''', is recently described, evolving [[kidney tumour]] that is presumed to be [[malignant]].<ref name=pmid26414221>{{Cite journal | last1 = Trpkov | first1 = K. | last2 = Hes | first2 = O. | last3 = Bonert | first3 = M. | last4 = Lopez | first4 = JI. | last5 = Bonsib | first5 = SM. | last6 = Nesi | first6 = G. | last7 = Comperat | first7 = E. | last8 = Sibony | first8 = M. | last9 = Berney | first9 = DM. | title = Eosinophilic, Solid, and Cystic Renal Cell Carcinoma: Clinicopathologic Study of 16 Unique, Sporadic Neoplasms Occurring in Women. | journal = Am J Surg Pathol | volume = | issue = | pages = | month = Sep | year = 2015 | doi = 10.1097/PAS.0000000000000508 | PMID = 26414221 }}</ref> | ||
It is ''not'' within the | It is ''not'' within the WHO 2016 classification of [[renal tumours|renal neoplasia]]. | ||
==General== | ==General== | ||
*Evolving entity. | *Evolving entity. | ||
*Similar to one of the three morphologic patterns of [[tuberous sclerosis-associated renal cell carcinoma]] described by Guo ''et al.''<ref name=pmid25093518>{{Cite journal | last1 = Guo | first1 = J. | last2 = Tretiakova | first2 = MS. | last3 = Troxell | first3 = ML. | last4 = Osunkoya | first4 = AO. | last5 = Fadare | first5 = O. | last6 = Sangoi | first6 = AR. | last7 = Shen | first7 = SS. | last8 = Lopez-Beltran | first8 = A. | last9 = Mehra | first9 = R. | title = Tuberous Sclerosis-associated Renal Cell Carcinoma: A Clinicopathologic Study of 57 Separate Carcinomas in 18 Patients. | journal = Am J Surg Pathol | volume = 38 | issue = 11 | pages = 1457-67 | month = Nov | year = 2014 | doi = 10.1097/PAS.0000000000000248 | PMID = 25093518 }}</ref> | *Similar to one of the three morphologic patterns of [[tuberous sclerosis-associated renal cell carcinoma]] described by Guo ''et al.''<ref name=pmid25093518>{{Cite journal | last1 = Guo | first1 = J. | last2 = Tretiakova | first2 = MS. | last3 = Troxell | first3 = ML. | last4 = Osunkoya | first4 = AO. | last5 = Fadare | first5 = O. | last6 = Sangoi | first6 = AR. | last7 = Shen | first7 = SS. | last8 = Lopez-Beltran | first8 = A. | last9 = Mehra | first9 = R. | title = Tuberous Sclerosis-associated Renal Cell Carcinoma: A Clinicopathologic Study of 57 Separate Carcinomas in 18 Patients. | journal = Am J Surg Pathol | volume = 38 | issue = 11 | pages = 1457-67 | month = Nov | year = 2014 | doi = 10.1097/PAS.0000000000000248 | PMID = 25093518 }}</ref> | ||
*Women only. | *Women only - in the initial series. | ||
==Gross== | ==Gross== | ||
| Line 47: | Line 47: | ||
Features:<ref name=pmid26414221/> | Features:<ref name=pmid26414221/> | ||
*Epithelioid cells with abundant stippled eosinophilic cytoplasm +/- peripheral clearing. | *Epithelioid cells with abundant stippled eosinophilic cytoplasm +/- peripheral clearing. | ||
*Round nuclei with prominent | *Round nuclei with one prominent [[nucleolus]]. | ||
*Nested or solid architecture +/- cystic spaces with [[hobnail]] lining cells. | *Nested or solid architecture +/- cystic spaces with [[hobnail]] lining cells. | ||
*+/-Scattered histiocytes (common). | *+/-Scattered histiocytes (common). | ||
| Line 59: | Line 59: | ||
*Other [[kidney tumours with eosinophilic cytoplasm]]. | *Other [[kidney tumours with eosinophilic cytoplasm]]. | ||
===Images=== | |||
====Case 1==== | |||
<gallery> | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma -- low mag.jpg | ESC-RCC - low mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma -- intermed mag.jpg | ESC-RCC - intermed. mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma -- high mag.jpg | ESC-RCC - high mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma -- very high mag.jpg | ESC-RCC - very high mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - solid -- intermed mag.jpg | ESC-RCC - intermed. mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - solid -- high mag.jpg | ESC-RCC - high mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - solid -- very high mag.jpg | ESC-RCC - very high mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - histiocytes -- intermed mag.jpg | ESC-RCC - intermed. mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - histiocytes -- high mag.jpg | ESC-RCC - high mag. | |||
</gallery> | |||
====Case 2==== | |||
<gallery> | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - 2 -- low mag.jpg | ESC-RCC - low mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - 2 -- intermed mag.jpg | ESC-RCC - intermed. mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - 2 -- high mag.jpg | ESC-RCC - high mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - 2 -- very high mag.jpg | ESC-RCC - very high mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - 2 alt -- high mag.jpg | ESC-RCC - high mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - 2 alt -- very high mag.jpg | ESC-RCC - very high mag. | |||
</gallery> | |||
====Case 3==== | |||
<gallery> | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - 3 -- low mag.jpg | ESC-RCC - low mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - 3 -- intermed mag.jpg | ESC-RCC - intermed. mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - 3 -- high mag.jpg | ESC-RCC - high mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - 3 -- very high mag.jpg | ESC-RCC - very high mag. | |||
</gallery> | |||
====Case 4==== | |||
<gallery> | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - 4 ~ intermed mag.jpg | ESC-RCC - intermed. mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - 4 ~ high mag.jpg | ESC-RCC - high mag. | |||
Image: Eosinophilic, solid and cystic renal cell carcinoma - 4 ~ very high mag.jpg | ESC-RCC - very high mag. | |||
</gallery> | |||
==IHC== | ==IHC== | ||
Features:<ref name=pmid26414221/> | Features:<ref name=pmid26414221/> | ||
*[[PAX8]] +ve. | *[[PAX8]] +ve. | ||
*[[CK20]] +ve. | *[[CK20]] +ve (14/19 cases).<ref name=pmid28786877 >{{Cite journal | last1 = Trpkov | first1 = K. | last2 = Abou-Ouf | first2 = H. | last3 = Hes | first3 = O. | last4 = Lopez | first4 = JI. | last5 = Nesi | first5 = G. | last6 = Comperat | first6 = E. | last7 = Sibony | first7 = M. | last8 = Osunkoya | first8 = AO. | last9 = Zhou | first9 = M. | title = Eosinophilic Solid and Cystic Renal Cell Carcinoma (ESC RCC): Further Morphologic and Molecular Characterization of ESC RCC as a Distinct Entity. | journal = Am J Surg Pathol | volume = 41 | issue = 10 | pages = 1299-1308 | month = Oct | year = 2017 | doi = 10.1097/PAS.0000000000000838 | PMID = 28786877 }}</ref> | ||
*[[CK7]] -ve. | *[[CK7]] -ve. | ||
*CD117 -ve. | *CD117 -ve. | ||
*CA9 -ve. | *CA9 -ve. | ||
*HMB-45 -ve. | *HMB-45 -ve. | ||
==Molecular== | |||
*[[Renal neoplasms with TSC/mTOR pathway mutations|TSC/mTOR pathway mutations]].<ref name=pmid35203531>{{cite journal |authors=Pivovarcikova K, Alaghehbandan R, Vanecek T, Ohashi R, Pitra T, Hes O |title=TSC/mTOR Pathway Mutation Associated Eosinophilic/Oncocytic Renal Neoplasms: A Heterogeneous Group of Tumors with Distinct Morphology, Immunohistochemical Profile, and Similar Genetic Background |journal=Biomedicines |volume=10 |issue=2 |pages= |date=January 2022 |pmid=35203531 |pmc=8869370 |doi=10.3390/biomedicines10020322 |url=}}</ref> | |||
==See also== | ==See also== | ||
Latest revision as of 03:16, 25 April 2024
| Eosinophilic, solid and cystic renal cell carcinoma | |
|---|---|
| Diagnosis in short | |
 Eosinophilic, solid and cystic renal cell carcinoma. H&E stain. | |
|
| |
| LM | epithelioid cells with abundant stippled eosinophilic cytoplasm +/- peripheral clearing, round nuclei with prominent nucleoli, nested or solid architecture +/- cystic spaces with hobnail lining cells, +/-scattered histiocytes (common), +/-multi-nucleation (common), +/-small intracytoplasmic globules |
| LM DDx | chromophobe renal cell carcinoma (eosinophilic variant), clear cell renal cell carcinoma, t(6;11) renal cell carcinoma, other renal tumours with eosinophilic cytoplasm |
| IHC | PAX8 +ve, CK20 +ve, CK7 -ve, CA9 -ve, CD117 -ve, HMB-45 -ve |
| Molecular | TSC/mTOR pathway mutations |
| Gross | solid and cystic |
| Site | kidney - see kidney tumours |
|
| |
| Clinical history | women only |
| Prevalence | rare |
| Prognosis | good - data limited |
| Clin. DDx | other kidney tumours |
Eosinophilic, solid and cystic renal cell carcinoma, abbreviated ESC-RCC, is recently described, evolving kidney tumour that is presumed to be malignant.[1]
It is not within the WHO 2016 classification of renal neoplasia.
General
- Evolving entity.
- Similar to one of the three morphologic patterns of tuberous sclerosis-associated renal cell carcinoma described by Guo et al.[2]
- Women only - in the initial series.
Gross
Features:[1]
- Tan colour.
- Solid and usually cystic.
Microscopic
Features:[1]
- Epithelioid cells with abundant stippled eosinophilic cytoplasm +/- peripheral clearing.
- Round nuclei with one prominent nucleolus.
- Nested or solid architecture +/- cystic spaces with hobnail lining cells.
- +/-Scattered histiocytes (common).
- +/-Multi-nucleation (common).
- +/-Small intracytoplasmic globules - usually seen but only present in a handful of cells.
DDx:
- Chromophobe renal cell carcinoma - perinuclear halos.
- Clear cell renal cell carcinoma, eosinophilic variant - chicken-wire vessels.
- Tuberous sclerosis-associated renal cell carcinoma.
- Other kidney tumours with eosinophilic cytoplasm.
Images
Case 1
ESC-RCC - low mag.
ESC-RCC - intermed. mag.
ESC-RCC - high mag.
ESC-RCC - very high mag.
ESC-RCC - intermed. mag.
ESC-RCC - high mag.
ESC-RCC - very high mag.
ESC-RCC - intermed. mag.
ESC-RCC - high mag.
Case 2
ESC-RCC - low mag.
ESC-RCC - intermed. mag.
ESC-RCC - high mag.
ESC-RCC - very high mag.
ESC-RCC - high mag.
ESC-RCC - very high mag.
Case 3
ESC-RCC - low mag.
ESC-RCC - intermed. mag.
ESC-RCC - high mag.
ESC-RCC - very high mag.
Case 4
ESC-RCC - intermed. mag.
ESC-RCC - high mag.
ESC-RCC - very high mag.
IHC
Features:[1]
Molecular
See also
References
- ↑ 1.0 1.1 1.2 1.3 Trpkov, K.; Hes, O.; Bonert, M.; Lopez, JI.; Bonsib, SM.; Nesi, G.; Comperat, E.; Sibony, M. et al. (Sep 2015). "Eosinophilic, Solid, and Cystic Renal Cell Carcinoma: Clinicopathologic Study of 16 Unique, Sporadic Neoplasms Occurring in Women.". Am J Surg Pathol. doi:10.1097/PAS.0000000000000508. PMID 26414221.
- ↑ Guo, J.; Tretiakova, MS.; Troxell, ML.; Osunkoya, AO.; Fadare, O.; Sangoi, AR.; Shen, SS.; Lopez-Beltran, A. et al. (Nov 2014). "Tuberous Sclerosis-associated Renal Cell Carcinoma: A Clinicopathologic Study of 57 Separate Carcinomas in 18 Patients.". Am J Surg Pathol 38 (11): 1457-67. doi:10.1097/PAS.0000000000000248. PMID 25093518.
- ↑ Trpkov, K.; Abou-Ouf, H.; Hes, O.; Lopez, JI.; Nesi, G.; Comperat, E.; Sibony, M.; Osunkoya, AO. et al. (Oct 2017). "Eosinophilic Solid and Cystic Renal Cell Carcinoma (ESC RCC): Further Morphologic and Molecular Characterization of ESC RCC as a Distinct Entity.". Am J Surg Pathol 41 (10): 1299-1308. doi:10.1097/PAS.0000000000000838. PMID 28786877.
- ↑ Pivovarcikova K, Alaghehbandan R, Vanecek T, Ohashi R, Pitra T, Hes O (January 2022). "TSC/mTOR Pathway Mutation Associated Eosinophilic/Oncocytic Renal Neoplasms: A Heterogeneous Group of Tumors with Distinct Morphology, Immunohistochemical Profile, and Similar Genetic Background". Biomedicines 10 (2). doi:10.3390/biomedicines10020322. PMC 8869370. PMID 35203531. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8869370/.