Difference between revisions of "Renal angiomyoadenomatous tumour"

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{{ Infobox diagnosis
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Name      = {{PAGENAME}}
| Image      =  
| Image      = Clear_cell_tubulopapillary_RCC_with_smooth_muscle_stroma_-_a2_--_intermed_mag.jpg
| Width      =
| Width      =
| Caption    =  
| Caption    = Renal cell carcinoma with clear cells and leiomyomatous bands. [[H&E stain]].
| Synonyms  =
| Synonyms  = renal cell carcinoma with angioleiomyoma-like stroma, renal cell carcinoma associated with prominent angioleiomyoma-like proliferation
| Micro      = leiomyomatous capsule of variable thickness, tubular structures with (1) apical snouts, and (2) clear cells with basal nuclei and mild [[nuclear atypia]]
| Micro      = leiomyomatous capsule of variable thickness, tubular structures with (1) apical snouts, and (2) clear cells with basal nuclei and mild [[nuclear atypia]]
| Subtypes  =
| Subtypes  =
| LMDDx      = [[clear cell renal cell carcinoma]], [[papillary renal cell carcinoma]], (epithelioid) [[angiomyolipoma]], [[mixed epithelial and stromal tumour of the kidney|mixed epithelial and stromal tumour]]
| LMDDx      = [[clear cell renal cell carcinoma]], [[papillary renal cell carcinoma]], (epithelioid) [[angiomyolipoma]], [[mixed epithelial and stromal tumour of the kidney|mixed epithelial and stromal tumour]], [[tuberous sclerosis-associated renal cell carcinoma]]
| Stains    =
| Stains    =
| IHC        = CK7 +ve, CK20 +ve, CAM5.2 +ve
| IHC        = CK7 +ve, CK20 +ve, CAM5.2 +ve
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| IF        =
| IF        =
| Gross      = tan-brown mass +/-cystic component
| Gross      = tan-brown mass +/-cystic component
| Grossing  =
| Grossing  = [[partial nephrectomy grossing]], [[total nephrectomy for tumour grossing]]
| Site      = [[kidney]] - see ''[[kidney tumours]]''
| Site      = [[kidney]] - see ''[[kidney tumours]]''
| Assdx      = possibly related to [[clear cell papillary renal cell carcinoma]]
| Assdx      = possibly related to [[clear cell papillary renal cell carcinoma]] - the WHO lumps this entity with it
| Syndromes  = RAT-like tumour seen in [[tuberous sclerosis]] - see ''[[tuberous sclerosis-associated renal cell carcinoma]]''
| Syndromes  =  
| Clinicalhx =
| Clinicalhx =
| Signs      =
| Signs      =
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''The [[Vancouver classification|Vancouver modification]] of the WHO classification''<ref name=pmid24025519>{{Cite journal  | last1 = Srigley | first1 = JR. | last2 = Delahunt | first2 = B. | last3 = Eble | first3 = JN. | last4 = Egevad | first4 = L. | last5 = Epstein | first5 = JI. | last6 = Grignon | first6 = D. | last7 = Hes | first7 = O. | last8 = Moch | first8 = H. | last9 = Montironi | first9 = R. | title = The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia. | journal = Am J Surg Pathol | volume = 37 | issue = 10 | pages = 1469-89 | month = Oct | year = 2013 | doi = 10.1097/PAS.0b013e318299f2d1 | PMID = 24025519 }}</ref> lumps it with [[clear cell papillary renal cell carcinoma]] (also known as ''clear cell tubulopapillary renal cell carcinoma'').
''The [[Vancouver classification|Vancouver modification]] of the WHO classification''<ref name=pmid24025519>{{Cite journal  | last1 = Srigley | first1 = JR. | last2 = Delahunt | first2 = B. | last3 = Eble | first3 = JN. | last4 = Egevad | first4 = L. | last5 = Epstein | first5 = JI. | last6 = Grignon | first6 = D. | last7 = Hes | first7 = O. | last8 = Moch | first8 = H. | last9 = Montironi | first9 = R. | title = The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia. | journal = Am J Surg Pathol | volume = 37 | issue = 10 | pages = 1469-89 | month = Oct | year = 2013 | doi = 10.1097/PAS.0b013e318299f2d1 | PMID = 24025519 }}</ref> lumps it with [[clear cell papillary renal cell carcinoma]] (also known as ''clear cell tubulopapillary renal cell carcinoma'').
Synonyms are '''renal cell carcinoma with angioleiomyoma-like stroma''' and '''renal cell carcinoma associated with prominent angioleiomyoma-like proliferation'''.<ref name=pmid25189644>{{Cite journal  | last1 = Williamson | first1 = SR. | last2 = Cheng | first2 = L. | last3 = Eble | first3 = JN. | last4 = True | first4 = LD. | last5 = Gupta | first5 = NS. | last6 = Wang | first6 = M. | last7 = Zhang | first7 = S. | last8 = Grignon | first8 = DJ. | title = Renal cell carcinoma with angioleiomyoma-like stroma: clinicopathological, immunohistochemical, and molecular features supporting classification as a distinct entity. | journal = Mod Pathol | volume = 28 | issue = 2 | pages = 279-94 | month = Feb | year = 2015 | doi = 10.1038/modpathol.2014.105 | PMID = 25189644 }}</ref>
It may be one and the same with [[TCEB1-mutated renal cell carcinoma]].


==General==
==General==
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DDx:<ref name=pmid22534244/><ref>{{Cite journal  | last1 = Petersson | first1 = F. | last2 = Branzovsky | first2 = J. | last3 = Martinek | first3 = P. | last4 = Korabecna | first4 = M. | last5 = Kruslin | first5 = B. | last6 = Hora | first6 = M. | last7 = Peckova | first7 = K. | last8 = Bauleth | first8 = K. | last9 = Pivovarcikova | first9 = K. | title = The leiomyomatous stroma in renal cell carcinomas is polyclonal and not part of the neoplastic process. | journal = Virchows Arch | volume = 465 | issue = 1 | pages = 89-96 | month = Jul | year = 2014 | doi = 10.1007/s00428-014-1591-9 | PMID = 24838683 }}</ref>
DDx:<ref name=pmid22534244/><ref>{{Cite journal  | last1 = Petersson | first1 = F. | last2 = Branzovsky | first2 = J. | last3 = Martinek | first3 = P. | last4 = Korabecna | first4 = M. | last5 = Kruslin | first5 = B. | last6 = Hora | first6 = M. | last7 = Peckova | first7 = K. | last8 = Bauleth | first8 = K. | last9 = Pivovarcikova | first9 = K. | title = The leiomyomatous stroma in renal cell carcinomas is polyclonal and not part of the neoplastic process. | journal = Virchows Arch | volume = 465 | issue = 1 | pages = 89-96 | month = Jul | year = 2014 | doi = 10.1007/s00428-014-1591-9 | PMID = 24838683 }}</ref>
*[[Clear cell papillary renal cell carcinoma]] - considered to be the same entity by WHO classification (see above).
*[[Clear cell renal cell carcinoma]].
*[[Clear cell renal cell carcinoma]].
*[[Papillary renal cell carcinoma]].
*[[Papillary renal cell carcinoma]].
*[[Angiomyolipoma]].
*[[Angiomyolipoma]].
*[[Mixed epithelial and stromal tumour of the kidney]].
*[[Mixed epithelial and stromal tumour of the kidney]].
*[[Clear cell papillary renal cell carcinoma]] - see above.
*[[Tuberous sclerosis-associated renal cell carcinoma]] - may have a RAT-like morphology.<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>
*[[Tuberous sclerosis-associated renal cell carcinoma]].
 
===Images===
<gallery>
Image: Clear cell tubulopapillary RCC with smooth muscle stroma -- low mag.jpg | CCTPRCC with SMS - low mag.
Image: Clear cell tubulopapillary RCC with smooth muscle stroma -- intermed mag.jpg | CCTPRCC with SMS - intermed. mag.
 
Image: Clear cell tubulopapillary RCC with smooth muscle stroma - a1 -- intermed mag.jpg | CCTPRCC with SMS - intermed. mag.
Image: Clear cell tubulopapillary RCC with smooth muscle stroma - a2 -- intermed mag.jpg | CCTPRCC with SMS - intermed. mag.
 
Image: Clear cell tubulopapillary RCC with smooth muscle stroma - b -- intermed mag.jpg | CCTPRCC with SMS - intermed. mag.
Image: Clear cell tubulopapillary RCC with smooth muscle stroma - b -- high mag.jpg | CCTPRCC with SMS - high mag.
</gallery>


==IHC==
==IHC==
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*CAM5.2 +ve.
*CAM5.2 +ve.
*AE1/AE3 +ve.
*AE1/AE3 +ve.
==Molecular==
*Possibly TCEB1 mutation - see ''[[TCEB1-mutated renal cell carcinoma]]''.


==See also==
==See also==
*[[Kidney tumours]].
*[[Kidney tumours]].
*[[Tuberous sclerosis]].
*[[Vancouver classification]].
*[[TCEB1-mutated renal cell carcinoma]].


==References==
==References==
48,466

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