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Difference between revisions of "Low-grade oncocytic renal tumour"
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| LMDDx = [[renal oncocytoma]], [[chromophobe renal cell carcinoma]] eosinophilic variant, [[clear cell renal cell carcinoma]] eosinophilic variant, [[papillary renal cell carcinoma]] oncocytic variant, [[tubulocystic carcinoma of the kidney]], other [[renal tumours with eosinophilic cytoplasm]], benign [[liver]] | | LMDDx = [[renal oncocytoma]], [[chromophobe renal cell carcinoma]] eosinophilic variant, [[clear cell renal cell carcinoma]] eosinophilic variant, [[papillary renal cell carcinoma]] oncocytic variant, [[tubulocystic carcinoma of the kidney]], other [[renal tumours with eosinophilic cytoplasm]], benign [[liver]] | ||
| Stains = | | Stains = | ||
| IHC = CK7 +ve, CD117 -ve, [[PAX8]] | | IHC = CK7 +ve, CD117 -ve, GATA3 +ve, [[PAX8]] +ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = TSC/mTOR pathway mutation | ||
| IF = | | IF = | ||
| Gross = | | Gross = | ||
| Line 19: | Line 19: | ||
| Clinicalhx = often incidentally discovered mass | | Clinicalhx = often incidentally discovered mass | ||
| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = | ||
| Prevalence = | | Prevalence = | ||
| Bloodwork = | | Bloodwork = | ||
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}} | }} | ||
'''Low-grade oncocytic renal tumour''', abbreviated '''LOT''', is an unusual [[renal tumour]] that does not neatly fit into any WHO renal neoplasia category. It is also known as '''renal oncocytic tumour that is CD117 negative and CK7 positive'''. | '''Low-grade oncocytic renal tumour''', abbreviated '''LOT''', is an unusual [[renal tumour]] that does not neatly fit into any WHO renal neoplasia category. It is also known as '''renal oncocytic tumour that is CD117 negative and CK7 positive'''. | ||
''Low-grade oncocytic tumour'' directs to here. | |||
Whether it is a distinct entity is not clear as of 2019.<ref name=pmid30895640/> It can be considered an emerging entity that may be in the WHO classification of renal neoplasia in the future.<ref name=pmid31936678>{{cite journal |authors=Siadat F, Trpkov K |title=ESC, ALK, HOT and LOT: Three Letter Acronyms of Emerging Renal Entities Knocking on the Door of the WHO Classification |journal=Cancers (Basel) |volume=12 |issue=1 |pages= |date=January 2020 |pmid=31936678 |pmc=7017067 |doi=10.3390/cancers12010168 |url=}}</ref> | Whether it is a distinct entity is not clear as of 2019.<ref name=pmid30895640/> It can be considered an emerging entity that may be in the WHO classification of renal neoplasia in the future.<ref name=pmid31936678>{{cite journal |authors=Siadat F, Trpkov K |title=ESC, ALK, HOT and LOT: Three Letter Acronyms of Emerging Renal Entities Knocking on the Door of the WHO Classification |journal=Cancers (Basel) |volume=12 |issue=1 |pages= |date=January 2020 |pmid=31936678 |pmc=7017067 |doi=10.3390/cancers12010168 |url=}}</ref> | ||
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*CK7 +ve. | *CK7 +ve. | ||
*[[GATA3]] +ve. | *[[GATA3]] +ve. | ||
** | **GATA3 very rarely positive in RCCs (1/71 clear cell RCC, 0/53 papillary RCC, 2/33 chromophobe RCC).<ref name=pmid2431520>{{cite journal |authors=Gonzalez-Roibon N, Faraj SF, Munari E, Bezerra SM, Albadine R, Sharma R, Argani P, Allaf ME, Netto GJ |title=Comprehensive profile of GATA binding protein 3 immunohistochemical expression in primary and metastatic renal neoplasms |journal=Hum Pathol |volume=45 |issue=2 |pages=244–8 |date=February 2014 |pmid=24315206 |doi=10.1016/j.humpath.2013.08.020 |url=}}</ref> | ||
** | **GATA3 occasionally positive in [[renal oncocytoma]] (9/47 cases).<ref name=pmid2431520/> | ||
*PAX8 +ve. | *PAX8 +ve. | ||
*CD117 -ve. | *CD117 -ve. | ||
| Line 76: | Line 78: | ||
*CK20 -ve. | *CK20 -ve. | ||
*CD10 -ve. | *CD10 -ve. | ||
*L1CAM +ve.<ref name=pmid38460672>{{cite journal |authors=Alghamdi M, Chen JF, Jungbluth A, Koutzaki S, Palmer MB, Al-Ahmadie HA, Fine SW, Gopalan A, Sarungbam J, Sirintrapun SJ, Tickoo SK, Reuter VE, Chen YB |title=L1CAM Expression and Molecular Alterations Distinguish Low Grade Oncocytic Tumor (LOT) from Eosinophilic Chromophobe Renal Cell Carcinoma |journal=Mod Pathol |volume= |issue= |pages=100467 |date=March 2024 |pmid=38460672 |doi=10.1016/j.modpat.2024.100467 |url=}}</ref> | |||
==Molecular== | |||
*[[Renal neoplasms with TSC/mTOR pathway mutations|TSC/mTOR pathway mutation]].<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> | |||
==Sign out== | ==Sign out== | ||
<pre> | <pre> | ||
Right Kidney Mass, Biopsy: | Right Kidney Mass, Biopsy: | ||
| Line 85: | Line 90: | ||
Comment: | Comment: | ||
The tumour stains as follows: | The tumour stains as follows: | ||
POSITIVE: CK7 (strong, diffuse | POSITIVE: CK7 (strong, diffuse), PAX8 (strong, diffuse), AE1/AE3, GATA-3 (moderate, diffuse). | ||
NEGATIVE: CD10, CK20, vimentin, CA9. | NEGATIVE: CD117, CD10, CK20, vimentin, CA9. | ||
It is in keeping with "low-grade oncocytic tumour" (LOT), an evolving entity. Based on limited data, LOT appears to have an indolent behavior. | |||
This tumour does not fit the diagnosis of renal oncocytoma or eosinophilic chromophobe renal cell carcinoma. | |||
</pre> | </pre> | ||
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==References== | ==References== | ||
{{Reflist| | {{Reflist|2}} | ||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Genitourinary pathology]] | [[Category:Genitourinary pathology]] | ||