Eosinophilic vacuolated tumour

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Eosinophilic vacuolated tumour
Diagnosis in short

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

Synonyms high-grade oncocytic tumour


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]




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





  • 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).



See also


  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.