Difference between revisions of "Kidney tumours"

Jump to navigation Jump to search

Kidney tumours (view source)

Revision as of 19:09, 3 November 2013

4,121 bytes removed ,  19:09, 3 November 2013
→‎Papillary renal cell carcinoma: redirect
Line 433: Line 433:


==Papillary renal cell carcinoma==
==Papillary renal cell carcinoma==
*Abbreviated ''PRCC'', ''PaRCC'' and ''papillary RCC''.
{{Main|Papillary 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>{{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>


==Chromophobe renal cell carcinoma==
==Chromophobe renal cell carcinoma==
Michael
48,833

edits

Retrieved from "https://librepathology.org/wiki/Special:MobileDiff/25461"

Navigation menu