Difference between revisions of "TFE3-rearranged renal cell carcinoma"

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{{ Infobox diagnosis
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Name      = {{PAGENAME}}
| Image      = Xp11.2_translocation_renal_cell_carcinoma_-_high_mag.jpg
| Image      = Xp11.2_translocation_renal_cell_carcinoma_-_high_mag.jpg  
| Width      =
| Width      =
| Caption    = Xp11.2 translocation carcinoma. [[H&E stain]].  
| Caption    = Xp11.2 translocation carcinoma. [[H&E stain]].  
| Synonyms  = Xp11 translocation renal cell carcinoma, renal tumour with Xp11 translocation, [[MiT family translocation renal cell carcinoma]] (obsolete term)
| Micro      = large cells with clear or eosinophilic cytoplasm, calcification (classic histomorphologic feature),  +/-papillae, +/-nests, +/-[[psammoma bodies]] (common), +/-[[hyaline bodies]] (common)
| Micro      = large cells with clear or eosinophilic cytoplasm, calcification (classic histomorphologic feature),  +/-papillae, +/-nests, +/-[[psammoma bodies]] (common), +/-[[hyaline bodies]] (common)
| Subtypes  =
| Subtypes  =
| LMDDx      = [[clear cell renal cell carcinoma]], [[papillary renal cell carcinoma]], [[epithelioid angiomyolipoma]], [[clear cell papillary renal cell carcinoma]]
| LMDDx      = [[clear cell renal cell carcinoma]], [[papillary renal cell carcinoma]], [[epithelioid angiomyolipoma]], [[clear cell papillary renal cell carcinoma]], [[unclassified renal cell carcinoma]], [[melanotic Xp11 translocation renal cancer]] (evolving entity)
| Stains    =
| Stains    =
| IHC        = TFE3 +ve (nucleus), CD10 +ve, vimentin +ve, CK7 -ve (usu.)
| IHC        = TFE3 +ve (nucleus), CD10 +ve, vimentin +ve, CK7 -ve (usu.)
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| IF        =
| IF        =
| Gross      =
| Gross      =
| Grossing  =
| Grossing  = [[total nephrectomy for tumour grossing]], [[partial nephrectomy grossing]]
| Staging    = [[kidney cancer staging]]
| Site      = [[kidney]] - see [[kidney tumours]]
| Site      = [[kidney]] - see [[kidney tumours]]
| Assdx      =
| Assdx      =
| Syndromes  =
| Syndromes  =
| Clinicalhx =
| Clinicalhx = children or younger adults
| Signs      =
| Signs      =
| Symptoms  =
| Symptoms  =
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| ClinDDx    = other [[kidney tumours]]
| ClinDDx    = other [[kidney tumours]]
}}
}}
'''Renal tumour with Xp11.2 translocation''', also '''Xp11.2 translocation carcinoma''', is an uncommon [[malignant]] [[kidney tumour]].
'''TFE3-rearranged renal cell carcinoma''' is a rare type of [[renal cell carcinoma]] recognized by the WHO classification as a distinct entity.<ref name=pmid36645398>{{cite journal |authors=Alaghehbandan R, Siadat F, Trpkov K |title=What's new in the WHO 2022 classification of kidney tumours? |journal=Pathologica |volume=115 |issue=1 |pages=8–22 |date=February 2022 |pmid=36645398 |pmc=10342217 |doi=10.32074/1591-951X-818 |url=}}</ref>
 
It was previously known as '''renal tumour with Xp11.2 translocation''', also '''Xp11.2 translocation carcinoma''' and '''Xp11 translocation renal cell carcinoma'''. It was previously lumped with other entities in the category [[MiT family translocation renal cell carcinoma]].
 
It should '''not''' be confused with ''[[TFEB-rearranged RCC]]'', another [[translocation carcinoma]] found in the [[kidney]].


==General==
==General==
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*[[Epithelioid angiomyolipoma]].
*[[Epithelioid angiomyolipoma]].
*[[Clear cell papillary renal cell carcinoma]].
*[[Clear cell papillary renal cell carcinoma]].
*[[Renal cell carcinoma, unclassified]].
*[[Adrenal gland]] - cortex.
*[[Melanotic Xp11 translocation renal cancer]] - an evolving entity that looks like Xp11 translocation carcinoma, keratin negative.<ref name=pmid19065101>{{Cite journal  | last1 = Argani | first1 = P. | last2 = Aulmann | first2 = S. | last3 = Karanjawala | first3 = Z. | last4 = Fraser | first4 = RB. | last5 = Ladanyi | first5 = M. | last6 = Rodriguez | first6 = MM. | title = Melanotic Xp11 translocation renal cancers: a distinctive neoplasm with overlapping features of PEComa, carcinoma, and melanoma. | journal = Am J Surg Pathol | volume = 33 | issue = 4 | pages = 609-19 | month = Apr | year = 2009 | doi = 10.1097/PAS.0b013e31818fbdff | PMID = 19065101 }}</ref>


===Images===
===Images===
====Case 1====
<gallery>
<gallery>
Image:Xp11.2_translocation_renal_cell_carcinoma_-_intermed_mag.jpg | Xp11.2 translocation RCC - intermed. mag. (WC/Nephron)
Image:Xp11.2_translocation_renal_cell_carcinoma_-_intermed_mag.jpg | Xp11.2 translocation RCC - intermed. mag. (WC/Nephron)
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Image:Xp11.2_translocation_renal_cell_carcinoma_-_very_high_mag.jpg | Xp11.2 translocation RCC - very high mag. (WC/Nephron)
Image:Xp11.2_translocation_renal_cell_carcinoma_-_very_high_mag.jpg | Xp11.2 translocation RCC - very high mag. (WC/Nephron)
</gallery>
</gallery>
www:
====Case 2====
<gallery>
Image: Translocation carcinoma - kidney -- low mag.jpg | TCK - low mag.
Image: Translocation carcinoma - kidney -- intermed mag.jpg | TCK - intermed. mag.
Image: Translocation carcinoma - kidney -- high mag.jpg | TCK - high mag.
Image: Translocation carcinoma - kidney - alt -- high mag.jpg | TCK - high mag.
Image: Translocation carcinoma - kidney -- very high mag.jpg | TCK - very high mag.
</gallery>
====www====
*[http://www.flickr.com/photos/40764007@N08/7403237732/in/photostream/ Translocation carcinoma (flickr.com)].
*[http://www.flickr.com/photos/40764007@N08/7403237732/in/photostream/ Translocation carcinoma (flickr.com)].


==IHC==
==IHC==
Key stains - as per [[ISUP]]:<ref name=pmid25025364 >{{cite journal |author=Amin MB, Epstein JI, Ulbright TM, ''et al.'' |title=Best practices recommendations in the application of immunohistochemistry in urologic pathology: report from the international society of urological pathology consensus conference |journal=Am. J. Surg. Pathol. |volume=38 |issue=8 |pages=1017–22 |year=2014 |month=August |pmid=25025364 |doi=10.1097/PAS.0000000000000254 |url=}}</ref>
Key stains - as per [[ISUP]]:<ref name=pmid25025364 >{{cite journal |author=Amin MB, Epstein JI, Ulbright TM, ''et al.'' |title=Best practices recommendations in the application of immunohistochemistry in urologic pathology: report from the international society of urological pathology consensus conference |journal=Am. J. Surg. Pathol. |volume=38 |issue=8 |pages=1017–22 |year=2014 |month=August |pmid=25025364 |doi=10.1097/PAS.0000000000000254 |url=}}</ref>
*TFE3 +ve (nucleus).<ref name=Ref_WMSP285>{{Ref WMSP|285}}</ref>
*TFE3 +ve (nucleus).<ref name=Ref_WMSP285>{{Ref WMSP|285}}</ref>
*TFEB +ve.
*TFEB +ve.
*Cathepsin K +ve.<ref name=pmid21602817>{{cite journal |author=Martignoni G, Gobbo S, Camparo P, ''et al.'' |title=Differential expression of cathepsin K in neoplasms harboring TFE3 gene fusions |journal=Mod. Pathol. |volume=24 |issue=10 |pages=1313–9 |year=2011 |month=October |pmid=21602817 |doi=10.1038/modpathol.2011.93 |url=}}</ref>
*Cathepsin K +ve.<ref name=pmid21602817>{{cite journal |author=Martignoni G, Gobbo S, Camparo P, ''et al.'' |title=Differential expression of cathepsin K in neoplasms harboring TFE3 gene fusions |journal=Mod. Pathol. |volume=24 |issue=10 |pages=1313–9 |year=2011 |month=October |pmid=21602817 |doi=10.1038/modpathol.2011.93 |url=}}</ref>
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*CK7 -ve.
*CK7 -ve.
**Positive in ~20% of cases.<ref name=pmid21804394>{{Cite journal  | last1 = He | first1 = H. | last2 = Zhou | first2 = GX. | last3 = Zhou | first3 = M. | last4 = Chen | first4 = L. | title = The distinction of clear cell carcinoma of the female genital tract, clear cell renal cell carcinoma, and translocation-associated renal cell carcinoma: an immunohistochemical study using tissue microarray. | journal = Int J Gynecol Pathol | volume = 30 | issue = 5 | pages = 425-30 | month = Sep | year = 2011 | doi = 10.1097/PGP.0b013e318214dd4f | PMID = 21804394 }}</ref>
**Positive in ~20% of cases.<ref name=pmid21804394>{{Cite journal  | last1 = He | first1 = H. | last2 = Zhou | first2 = GX. | last3 = Zhou | first3 = M. | last4 = Chen | first4 = L. | title = The distinction of clear cell carcinoma of the female genital tract, clear cell renal cell carcinoma, and translocation-associated renal cell carcinoma: an immunohistochemical study using tissue microarray. | journal = Int J Gynecol Pathol | volume = 30 | issue = 5 | pages = 425-30 | month = Sep | year = 2011 | doi = 10.1097/PGP.0b013e318214dd4f | PMID = 21804394 }}</ref>
*HMB-45 & Melan A -ve.
*HMB-45 -ve.
**Positive in ''epithelioid [[angiomyolipoma]]''.
**Positive in ''epithelioid [[angiomyolipoma]]''.
*Melan A -ve/+ve.<ref name=pmid22207547>{{Cite journal  | last1 = Kuroda | first1 = N. | last2 = Mikami | first2 = S. | last3 = Pan | first3 = CC. | last4 = Cohen | first4 = RJ. | last5 = Hes | first5 = O. | last6 = Michal | first6 = M. | last7 = Nagashima | first7 = Y. | last8 = Tanaka | first8 = Y. | last9 = Inoue | first9 = K. | title = Review of renal carcinoma associated with Xp11.2 translocations/TFE3 gene fusions with focus on pathobiological aspect. | journal = Histol Histopathol | volume = 27 | issue = 2 | pages = 133-40 | month = Feb | year = 2012 | doi =  | PMID = 22207547 }}</ref>
**Should exclude adrenal if +ve.
*EMA usually -ve.<ref name=pmid20679884>{{Cite journal  | last1 = Argani | first1 = P. | last2 = Hicks | first2 = J. | last3 = De Marzo | first3 = AM. | last4 = Albadine | first4 = R. | last5 = Illei | first5 = PB. | last6 = Ladanyi | first6 = M. | last7 = Reuter | first7 = VE. | last8 = Netto | first8 = GJ. | title = Xp11 translocation renal cell carcinoma (RCC): extended immunohistochemical profile emphasizing novel RCC markers. | journal = Am J Surg Pathol | volume = 34 | issue = 9 | pages = 1295-303 | month = Sep | year = 2010 | doi = 10.1097/PAS.0b013e3181e8ce5b | PMID = 20679884 }}</ref>
*EMA usually -ve.<ref name=pmid20679884>{{Cite journal  | last1 = Argani | first1 = P. | last2 = Hicks | first2 = J. | last3 = De Marzo | first3 = AM. | last4 = Albadine | first4 = R. | last5 = Illei | first5 = PB. | last6 = Ladanyi | first6 = M. | last7 = Reuter | first7 = VE. | last8 = Netto | first8 = GJ. | title = Xp11 translocation renal cell carcinoma (RCC): extended immunohistochemical profile emphasizing novel RCC markers. | journal = Am J Surg Pathol | volume = 34 | issue = 9 | pages = 1295-303 | month = Sep | year = 2010 | doi = 10.1097/PAS.0b013e3181e8ce5b | PMID = 20679884 }}</ref>
*CD117 -ve (0 +ve/21 cases<ref name=pmid20679884/>).
*CD117 -ve (0 +ve/21 cases<ref name=pmid20679884/>).
*CK (pooled) -ve.<ref name=pmid20679884/> (???)
*CK (pooled) -ve.<ref name=pmid20679884/> (???)
*WT1 -ve (0 +ve/21 cases<ref name=pmid20679884/>).
*WT1 -ve (0 +ve/21 cases<ref name=pmid20679884/>).
*PAX8 +ve (16 +ve/21<ref name=pmid20679884/>).


Notes:
Notes:
*Poor man's panel - if one doesn't have the more informative stains:  
*Poor man's panel - if one doesn't have the more informative stains:  
**CK (pooled), EMA, Melan A, HMB-45, CK7, AMACR, CD10, vimentin.
**CK (pooled), EMA, Melan A, HMB-45, CK7, AMACR, CD10, vimentin, RCC.
*‡ The IHC (in comparsion to FISH) has both false negatives and false positives; in one study by Qu ''et al.'' the false positive rate was 7% (2/30) and false negative rate was 4% (2/46).<ref>{{Cite journal  | last1 = Qu | first1 = Y. | last2 = Gu | first2 = C. | last3 = Wang | first3 = H. | last4 = Chang | first4 = K. | last5 = Yang | first5 = X. | last6 = Zhou | first6 = X. | last7 = Dai | first7 = B. | last8 = Zhu | first8 = Y. | last9 = Shi | first9 = G. | title = Diagnosis of adults Xp11.2 translocation renal cell carcinoma by immunohistochemistry and FISH assays: clinicopathological data from ethnic Chinese population. | journal = Sci Rep | volume = 6 | issue =  | pages = 21677 | month =  | year = 2016 | doi = 10.1038/srep21677 | PMID = 26880493 }}</ref>


==Molecular==
==Molecular==
*[[Translocation]] involving TFE3.<ref name=Ref_WMSP285>{{Ref WMSP|285}}</ref>
*[[Translocation]] involving TFE3.<ref name=Ref_WMSP285>{{Ref WMSP|285}}</ref>
**A very low list of partners have been described.


The most common are:<ref name=pmid24309327 >{{Cite journal  | last1 = Ellis | first1 = CL. | last2 = Eble | first2 = JN. | last3 = Subhawong | first3 = AP. | last4 = Martignoni | first4 = G. | last5 = Zhong | first5 = M. | last6 = Ladanyi | first6 = M. | last7 = Epstein | first7 = JI. | last8 = Netto | first8 = GJ. | last9 = Argani | first9 = P. | title = Clinical heterogeneity of Xp11 translocation renal cell carcinoma: impact of fusion subtype, age, and stage. | journal = Mod Pathol | volume =  | issue =  | pages =  | month = Dec | year = 2013 | doi = 10.1038/modpathol.2013.208 | PMID = 24309327 }}</ref>
The most common are:<ref name=pmid24309327 >{{Cite journal  | last1 = Ellis | first1 = CL. | last2 = Eble | first2 = JN. | last3 = Subhawong | first3 = AP. | last4 = Martignoni | first4 = G. | last5 = Zhong | first5 = M. | last6 = Ladanyi | first6 = M. | last7 = Epstein | first7 = JI. | last8 = Netto | first8 = GJ. | last9 = Argani | first9 = P. | title = Clinical heterogeneity of Xp11 translocation renal cell carcinoma: impact of fusion subtype, age, and stage. | journal = Mod Pathol | volume =  | issue =  | pages =  | month = Dec | year = 2013 | doi = 10.1038/modpathol.2013.208 | PMID = 24309327 }}</ref>
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==See also==
==See also==
*[[Kidney tumours]].
*[[Kidney tumours]].
*[[Chromosomal translocation]].


==References==
==References==
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[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Kidney tumours]]
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