Collecting duct carcinoma

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Collecting duct carcinoma
Diagnosis in short

Collecting duct carcinoma. (WC/George Netto)

LM tubular structures with tapered ends, hobnail pattern, nuclear pleomorphism), high mitotic rate
LM DDx papillary renal cell carcinoma (type 2), urothelial carcinoma (with glandular differentiation), metastatic adenocarcinoma, renal medullary carcinoma
IHC CD117 +ve, CK7 +ve, PAX8 +ve, CD10 -ve, AMACR -ve, p63 -ve
Gross medullary tumour
Grossing notes total nephrectomy for tumour grossing, partial nephrectomy grossing
Staging kidney cancer staging
Site kidney - see kidney tumours

Prevalence very rare
Prognosis poor
Clin. DDx other renal tumours

Collecting duct carcinoma, also known as Bellini duct carcinoma[1] and carcinoma of the collecting ducts of Bellini, is a rare aggressive kidney tumour.

It should not be confused with tubulocystic carcinoma of the kidney (also known as low-grade collecting duct carcinoma).

General

  • Rare.
  • Poor prognosis.
  • Usually central location.
  • Typically young adults.

Gross

  • Medullary location - as opposed to cortical.[2]

Microscopic

Features:[3]

  • Tubular structures with tapered ends.
    • May be described as tubulopapillary.
  • Hobnail pattern - cell width smaller at basement membrane than free surface.[4]
  • High grade nuclear features (nuclear pleomorphism).
  • High mitotic rate.

Notes:

  • Benign urothelium must present to excluded urothelial carcinoma.
  • Desmoplastic stroma may be prominent.

DDx:

Images

www

IHC

Features:[6]

  • HMWCK +ve.
  • LMWCK +ve.
  • CD117 +ve.
  • E-cadherin +ve.
  • CD10 -ve.
  • AMACR -ve.
  • PAX8 +ve.[7]

UCC:

  • CK20 +ve.[6]
  • p63 +ve.[7]
  • CK5/6 +ve.
  • PAX8 -ve.[7]

Others:

See also

References

  1. Stamatiou, K.; Zizi-Sermpetzoglou, A.. "Bellini duct carcinoma accidentally found upon investigation of uric acid lithiasis.". Indian J Pathol Microbiol 54 (1): 229-30. doi:10.4103/0377-4929.77425. PMID 21393935.
  2. López, JI.; Larrinaga, G.; Kuroda, N.; Angulo, JC. (Apr 2015). "The normal and pathologic renal medulla: a comprehensive overview.". Pathol Res Pract 211 (4): 271-80. doi:10.1016/j.prp.2014.12.009. PMID 25595996.
  3. Zhou, Ming; Magi-Galluzzi, Cristina (2006). Genitourinary Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 295. ISBN 978-0443066771.
  4. Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 1018. ISBN 0-7216-0187-1.
  5. Prasad, SR.; Humphrey, PA.; Catena, JR.; Narra, VR.; Srigley, JR.; Cortez, AD.; Dalrymple, NC.; Chintapalli, KN.. "Common and uncommon histologic subtypes of renal cell carcinoma: imaging spectrum with pathologic correlation.". Radiographics 26 (6): 1795-806; discussion 1806-10. doi:10.1148/rg.266065010. PMID 17102051.
  6. 6.0 6.1 Srigley, JR.; Delahunt, B. (Jun 2009). "Uncommon and recently described renal carcinomas.". Mod Pathol 22 Suppl 2: S2-S23. doi:10.1038/modpathol.2009.70. PMID 19494850.
  7. 7.0 7.1 7.2 Albadine, R.; Schultz, L.; Illei, P.; Ertoy, D.; Hicks, J.; Sharma, R.; Epstein, JI.; Netto, GJ. (Jul 2010). "PAX8 (+)/p63 (-) immunostaining pattern in renal collecting duct carcinoma (CDC): a useful immunoprofile in the differential diagnosis of CDC versus urothelial carcinoma of upper urinary tract.". Am J Surg Pathol 34 (7): 965-9. doi:10.1097/PAS.0b013e3181dc5e8a. PMID 20463571.
  8. Kim, MK.; Kim, S. (Dec 2002). "Immunohistochemical profile of common epithelial neoplasms arising in the kidney.". Appl Immunohistochem Mol Morphol 10 (4): 332-8. PMID 12613443.
  9. Merino, MJ.; Torres-Cabala, C.; Pinto, P.; Linehan, WM. (Oct 2007). "The morphologic spectrum of kidney tumors in hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome.". Am J Surg Pathol 31 (10): 1578-85. doi:10.1097/PAS.0b013e31804375b8. PMID 17895761.