Eosinophilic, solid and cystic renal cell carcinoma

From Libre Pathology
Jump to navigation Jump to search
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
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 Vancouver classification of renal tumours.[2]

General

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:

Images

Case 1

Case 2

Case 3

IHC

Features:[1]

  • PAX8 +ve.
  • CK20 +ve.
  • CK7 -ve.
  • CD117 -ve.
  • CA9 -ve.
  • HMB-45 -ve.

See also

References

  1. 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.
  2. Srigley, JR.; Delahunt, B.; Eble, JN.; Egevad, L.; Epstein, JI.; Grignon, D.; Hes, O.; Moch, H. et al. (Oct 2013). "The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia.". Am J Surg Pathol 37 (10): 1469-89. doi:10.1097/PAS.0b013e318299f2d1. PMID 24025519.
  3. 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.