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Papillary renal cell carcinoma (view source)
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'''Papillary renal cell carcinoma''', abbreviated '''PRCC''', '''PaRCC''' and '''papillary RCC''', is the second most common type of [[renal cell carcinoma]]. | |||
==General== | |||
*Often subclassified<ref name=Ref_GUP289>{{Ref GUP|289}}</ref> into ''type 1'' and ''type 2'' -- see ''microscopic''. | |||
**Type 1 and Type 2 are different on a cytogenetic and molecular basis.<ref>{{Cite journal | last1 = Klatte | first1 = T. | last2 = Pantuck | first2 = AJ. | last3 = Said | first3 = JW. | last4 = Seligson | first4 = DB. | last5 = Rao | first5 = NP. | last6 = LaRochelle | first6 = JC. | last7 = Shuch | first7 = B. | last8 = Zisman | first8 = A. | last9 = Kabbinavar | first9 = FF. | title = Cytogenetic and molecular tumor profiling for type 1 and type 2 papillary renal cell carcinoma. | journal = Clin Cancer Res | volume = 15 | issue = 4 | pages = 1162-9 | month = Feb | year = 2009 | doi = 10.1158/1078-0432.CCR-08-1229 | PMID = 19228721 }}</ref> | |||
===Epidemiology=== | |||
*Associated with ''[[acquired renal cystic disease]]''.<ref name=Ref_DARP438>{{Ref DARP|438}}</ref> | |||
*May be familial. | |||
==Microscopic== | |||
Features:<ref name=Ref_PBoD1017-8>{{Ref PBoD|1017-8}}</ref> | |||
*Cuboidal or low columnar cell in papillae. | |||
*Interstitial foam cells in vascular cores - '''key feature'''.<ref>ALS Feb 9, 2009.</ref> | |||
**Most sensitive and specific feature of PRCC.<ref>{{cite journal |author=Granter SR, Perez-Atayde AR, Renshaw AA |title=Cytologic analysis of papillary renal cell carcinoma |journal=Cancer |volume=84 |issue=5 |pages=303?8 |year=1998 |month=October |pmid=9801205 |doi= |url=http://dx.doi.org/10.1002/(SICI)1097-0142(19981025)84:5<303::AID-CNCR6>3.0.CO;2-7}}</ref> | |||
*Highly vascular. | |||
Size criterion: | |||
*Papillary lesions '''''must''''' be >0.5 cm to be called ''carcinoma''; smaller lesions (<=0.5 cm) are called ''[[renal papillary adenoma|papillary adenoma]]s''.<ref name=Ref_GUP288>{{Ref GUP|288}}</ref> | |||
Mnemonic ''HIP'': '''h'''ighly vascular, '''i'''nterstitial foam cells, '''p'''apillae. | |||
DDx: | |||
*Clear cell RCC. | |||
**Papillary: +histiocytes, +intracellular hemosiderin, [[CK7]]+. | |||
*[[Clear cell papillary renal cell carcinoma]]. | |||
*[[Metanephric adenoma]] - esp. solid PRCC type 1. | |||
*[[Collecting duct carcinoma]] - esp. PRCC type 2. | |||
*[[Renal papillary adenoma]]. | |||
===Images=== | |||
<gallery> | |||
Image:Papillary_renal_cell_carcinoma_intermed_mag.jpg| PaRCC - intermed. mag. (WC/Nephron) | |||
Image:Papillary_renal_cell_carcinoma_very_high_mag.jpg| PaRCC - high mag. (WC/Nephron) | |||
</gallery> | |||
===Histological subtyping=== | |||
Subtypes:<ref name=Ref_GUP289>{{Ref GUP|289}}</ref> | |||
*''Type 1'' - single layer of cells on basement membrane. | |||
** usually low grade nuclear features, i.e. low Fuhrman grade. | |||
*''Type 2'' - pseudostratification of cells. | |||
** Usually high grade nuclear features, i.e. high Fuhrman grade. | |||
Others: | |||
*''Oncocytic'' - oncocytic cytoplasm. | |||
**Extremely rare ~ largest series is 12 cases.<ref name=pmid19494850 >{{Cite journal | last1 = Srigley | first1 = JR. | last2 = Delahunt | first2 = B. | title = Uncommon and recently described renal carcinomas. | journal = Mod Pathol | volume = 22 Suppl 2 | issue = | pages = S2-S23 | month = Jun | year = 2009 | doi = 10.1038/modpathol.2009.70 | PMID = 19494850 }}</ref> | |||
==IHC== | |||
Features:<ref name=Ref_GUP289>{{Ref GUP|289}}</ref> | |||
*AMACR +ve.<ref>ALS Feb 9, 2009.</ref> | |||
*HMWCK (34betaE12) +ve. | |||
*Panker (AE1/AE3) +ve. | |||
*CK7 +ve ~90% of type 1, 20% of type 2. | |||
More reading: | |||
*[http://www.e-immunohistochemistry.info/web/Papillary_renal_cell_carcinoma.htm e-immunohistochemistry.info] | |||
==Molecular== | |||
Features:<ref name=Ref_PBoD1016>{{Ref PBoD|1016}}</ref> | |||
*Sporadic: trisomies 7, 16, 17. | |||
*Familial: trisomy 7. | |||
**Chromosome 7 = location of MET gene. | |||
Note: | |||
*Not used for diagnosis.<ref>{{Ref WMSP|292}}</ref> | |||
==Sign out== | |||
<pre> | |||
KIDNEY, RIGHT, NEPHRECTOMY: | |||
- PAPILLARY RENAL CELL CARCINOMA, ONCOCYTIC -- SEE COMMENT; | |||
- FUHRMANN GRADE 2; | |||
- SURGICAL MARGINS NEGATIVE; | |||
- PLEASE SEE TUMOUR SUMMARY. | |||
COMMENT: | |||
The oncocytic variant of papillary renal cell carcinoma (RCC) is uncommon and not widely | |||
recognized as a subtype of papillary RCC. The prognostic significance of the oncocytic | |||
cytoplasm is uncertain.[1] The histomorphology in this case is compatible with a type 1 | |||
papillary RCC. | |||
1. Ann Diagn Pathol. 2006 Jun;10(3):133-9. | |||
</pre> | |||
==See also== | |||
*[[Kidney tumours]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Kidney tumours]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||