Difference between revisions of "Eosinophilic vacuolated tumour"

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'''High-grade oncocytic renal tumour''', abbreviated '''HOT''', is a [[kidney tumour]] type currently not recognized by the WHO classification as per the 2016 Blue Book.
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = High-grade oncocytic renal tumour -- high mag.jpg
| Width      =
| Caption    = Micrograph of a high-grade oncocytic tumour of the kidney. [[H&E stain]].
| Synonyms  = high-grade oncocytic tumour
| Micro      = abundant oncocytic cytoplasm with prominent intracytoplasmic vacuoles,
round nuclei, [[prominent nucleoli]] ([[ISUP nucleolar grade]] 3), no perinuclear halos
| Subtypes  =
| LMDDx      = [[renal oncocytoma]], [[renal hybrid oncocytic/chromophobe tumour]], [[chromophobe renal cell carcinoma]], other [[renal tumours with eosinophilic cytoplasm]]
| Stains    =
| IHC        = PAX8 +ve, CD117 +ve, CD10 +ve, SDHB +ve, TFE3 -ve
| EM        =
| Molecular  = TSC1 or TSC2 mutation
| IF        =
| Gross      =
| Grossing  =
| Staging    =
| Site      = [[kidney]] - see ''[[kidney tumours]]''
| Assdx      =
| Syndromes  = [[tuberous sclerosis]]
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = very rare? (evolving entity)
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = unknown (evolving entity)
| Other      =
| ClinDDx    = other [[renal tumours]]
| Tx        = excision
}}
'''Eosinophilic vacuolated tumour''', abbreviated '''EVT''', is a [[kidney tumour]] type currently not recognized by the WHO classification as per the 2016 Blue Book.
 
It was previously known as '''high-grade oncocytic tumour''', abbreviated '''HOT'''.<ref name=pmid34521993>{{cite journal |authors=Farcaş M, Gatalica Z, Trpkov K, Swensen J, Zhou M, Alaghehbandan R, Williamson SR, Magi-Galluzzi C, Gill AJ, Tretiakova M, Lopez JI, Montiel DP, Sperga M, Comperat E, Brimo F, Yilmaz A, Siadat F, Sangoi A, Gao Y, Ptákova N, Kuthi L, Pivovarcikova K, Rogala J, Agaimy A, Hartmann A, Fraune C, Rychly B, Hurnik P, Durcansky D, Bonert M, Gakis G, Michal M, Hora M, Hes O |title=Eosinophilic vacuolated tumor (EVT) of kidney demonstrates sporadic TSC/MTOR mutations: next-generation sequencing multi-institutional study of 19 cases |journal=Mod Pathol |volume= |issue= |pages= |date=September 2021 |pmid=34521993 |doi=10.1038/s41379-021-00923-6 |url=}}</ref>


==General==
==General==
*Previously lumped into ''[[renal hybrid oncocytic/chromophobe tumour]]''.
*Previously lumped into ''[[renal hybrid oncocytic/chromophobe tumour]]''.
*Evolving entity.
*May be seen within the context of [[tuberous sclerosis]].<ref name=pmid31002177>{{Cite journal  | last1 = Trpkov | first1 = K. | last2 = Bonert | first2 = M. | last3 = Gao | first3 = Y. | last4 = Kapoor | first4 = A. | last5 = He | first5 = H. | last6 = Yilmaz | first6 = A. | last7 = Gill | first7 = AJ. | last8 = Williamson | first8 = SR. | last9 = Comperat | first9 = E. | title = High-grade oncocytic tumour (HOT) of kidney in a patient with tuberous sclerosis complex. | journal = Histopathology | volume =  | issue =  | pages =  | month = Apr | year = 2019 | doi = 10.1111/his.13876 | PMID = 31002177 }}</ref>


==Microscopic==
==Microscopic==
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*[[Chromophobe renal cell carcinoma]].
*[[Chromophobe renal cell carcinoma]].
*Other [[renal tumours with eosinophilic cytoplasm]].
*Other [[renal tumours with eosinophilic cytoplasm]].
===Images===
<gallery>
Image: High-grade oncocytic renal tumour -- low mag.jpg | HOT - low mag. (WC)
Image: High-grade oncocytic renal tumour -- intermed mag.jpg | HOT - intermed. mag. (WC)
Image: High-grade oncocytic renal tumour - alt -- intermed mag.jpg | HOT - intermed. mag. (WC)
Image: High-grade oncocytic renal tumour -- high mag.jpg | HOT - high mag. (WC)
Image: High-grade oncocytic renal tumour - alt -- high mag.jpg | HOT - high mag. (WC)
Image: High-grade oncocytic renal tumour -- very high mag.jpg | HOT - very high mag. (WC)
</gallery>


==IHC==
==IHC==
Features:<ref name=pmid30232607/>
Features:<ref name=pmid30232607/>
*PAX8 +ve (13 of 13 cases).
*PAX8 +ve.
*AE1/AE3 +ve.
*AE1/AE3 +ve.
*CK18 +ve.
*CK18 +ve.
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*Melan A -ve.
*Melan A -ve.
*TFE3 -ve.
*TFE3 -ve.
*[[CD117]] +ve (9 of 14 cases).
Others:
*CD56 +ve.{{fact}}
**Typically negative in [[renal oncocytoma]].
==Molecular==
*TSC1 or TSC2 mutation - see [[renal neoplasms with TSC/mTOR pathway mutations]].


==See also==
==See also==
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==References==
==References==
{{Reflist|1}}
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]

Latest revision as of 04:15, 20 March 2024

Eosinophilic vacuolated tumour
Diagnosis in short

Micrograph of a high-grade oncocytic tumour of the kidney. H&E stain.

Synonyms high-grade oncocytic tumour

LM

abundant oncocytic cytoplasm with prominent intracytoplasmic vacuoles,

round nuclei, prominent nucleoli (ISUP nucleolar grade 3), no perinuclear halos
LM DDx renal oncocytoma, renal hybrid oncocytic/chromophobe tumour, chromophobe renal cell carcinoma, other renal tumours with eosinophilic cytoplasm
IHC PAX8 +ve, CD117 +ve, CD10 +ve, SDHB +ve, TFE3 -ve
Molecular TSC1 or TSC2 mutation
Site kidney - see kidney tumours

Syndromes tuberous sclerosis

Prevalence very rare? (evolving entity)
Prognosis unknown (evolving entity)
Clin. DDx other renal tumours
Treatment excision

Eosinophilic vacuolated tumour, abbreviated EVT, is a kidney tumour type currently not recognized by the WHO classification as per the 2016 Blue Book.

It was previously known as high-grade oncocytic tumour, abbreviated HOT.[1]

General

Microscopic

Features:[3]

  • Abundant oncocytic cytoplasm with prominent intracytoplasmic vacuoles.
  • Round nuclei
  • Prominent nucleoli (ISUP nucleolar grade 3).
  • No perinuclear halos.

DDx:

Images

IHC

Features:[3]

  • PAX8 +ve.
  • AE1/AE3 +ve.
  • CK18 +ve.
  • SDHB +ve.
  • CD10 +ve (12 of 13 cases).
  • HMB45 -ve.
  • Melan A -ve.
  • TFE3 -ve.
  • CD117 +ve (9 of 14 cases).

Others:

Molecular

See also

References

  1. Farcaş M, Gatalica Z, Trpkov K, Swensen J, Zhou M, Alaghehbandan R, Williamson SR, Magi-Galluzzi C, Gill AJ, Tretiakova M, Lopez JI, Montiel DP, Sperga M, Comperat E, Brimo F, Yilmaz A, Siadat F, Sangoi A, Gao Y, Ptákova N, Kuthi L, Pivovarcikova K, Rogala J, Agaimy A, Hartmann A, Fraune C, Rychly B, Hurnik P, Durcansky D, Bonert M, Gakis G, Michal M, Hora M, Hes O (September 2021). "Eosinophilic vacuolated tumor (EVT) of kidney demonstrates sporadic TSC/MTOR mutations: next-generation sequencing multi-institutional study of 19 cases". Mod Pathol. doi:10.1038/s41379-021-00923-6. PMID 34521993.
  2. Trpkov, K.; Bonert, M.; Gao, Y.; Kapoor, A.; He, H.; Yilmaz, A.; Gill, AJ.; Williamson, SR. et al. (Apr 2019). "High-grade oncocytic tumour (HOT) of kidney in a patient with tuberous sclerosis complex.". Histopathology. doi:10.1111/his.13876. PMID 31002177.
  3. 3.0 3.1 He, H.; Trpkov, K.; Martinek, P.; Isikci, OT.; Maggi-Galuzzi, C.; Alaghehbandan, R.; Gill, AJ.; Tretiakova, M. et al. (Dec 2018). ""High-grade oncocytic renal tumor": morphologic, immunohistochemical, and molecular genetic study of 14 cases.". Virchows Arch 473 (6): 725-738. doi:10.1007/s00428-018-2456-4. PMID 30232607.