Parafibromin as a new immunohistochemistry staining to improve pathologic diagnosis of renal oncocytoma: Analysis of 225 renal tumors.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 408-408 ◽  
Author(s):  
L. Albiges ◽  
J. Couturier ◽  
Y. Allory ◽  
P. Camparo ◽  
M. Sibony ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Tumor ◽  
Diagnostic Value ◽  
Renal Clear Cell Carcinoma ◽  
Renal Tumors ◽  
Renal Oncocytoma ◽  
Positive Staining ◽  
Tissue Micro Array ◽  
Tumor Subtypes

408 Background: Chromophobe renal cell carcinoma (chRCC) and renal oncocytoma (Onc) are two distinct but closely related entities with strong morphologic and genetic similarities. While chRCC is a malignant tumor, Onc is usually considered as a benign entity. Recently, gene expression profiling applied on chRCC and Onc identified new potential markers that may effectively discriminate the 2 pathologic entities, including parafibromin. This work aims at evaluating the diagnostic value of Parafibromin (Pf) immuno staining on a large number of renal tumor samples. Methods: Sixty-three renal clear cell carcinoma (ccRCC), 47 papillary (Pap), 40 chRCC, and 75 Onc were immunostained for parafibromin antibody (1/200; Santacruz Biotechnology), on a tissue micro array. Results: Parafibromin was positive in 38.6% of Onc, vs 5% of chRCC (p < 0.001), with a 95% specificity, and the positive predictive value observed for parafibromin was 94%. For other tumor types, a positive staining for parafibromin was observed in 7.9% and 8.5% in ccRCC and Pap respectively. Conclusions: Parafibromin is a recently identified protein which seems to be specific for oncocytoma, and highly discriminant for other histologic renal cell tumor subtypes, especially for chromophobe. IHC may help to optimize therapeutics strategy for small renal mass and avoid surgical resection of benign lesions in some patients.Validation of this staining on renal tumor biopsies is on going.The value of the combination of this new immunostaining associated with the three standard IHC staining (CK7, CD117, E Cad) will be provided at the meeting. [Table: see text] No significant financial relationships to disclose.

scholarly journals Differential Diagnosis of Renal Tumors With Clear Cytoplasm: Clinical Relevance of Renal Tumor Subclassification in the Era of Targeted Therapies and Personalized Medicine

2013 ◽  
Vol 137 (4) ◽  
pp. 467-480 ◽  
Author(s):  
Rajen Goyal ◽  
Elizabeth Gersbach ◽  
Ximing J. Yang ◽  
Stephen M. Rohan
Keyword(s):  
Renal Cell Carcinoma ◽  
Differential Diagnosis ◽  
Cell Carcinoma ◽  
Targeted Therapies ◽  
Renal Cell ◽  
Clear Cell ◽  
Renal Tumor ◽  
Renal Tumors ◽  
Cell Renal Cell Carcinoma ◽  
Immunohistochemical Stains

Context.—The World Health Organization classification of renal tumors synthesizes morphologic, immunohistochemical, and molecular findings to define more than 40 tumor types. Of these, clear cell (conventional) renal cell carcinoma is the most common malignant tumor in adults and—with the exception of some rare tumors—the most deadly. The diagnosis of clear cell renal cell carcinoma on morphologic grounds alone is generally straightforward, but challenging cases are not infrequent. A misdiagnosis of clear cell renal cell carcinoma has clinical consequences, particularly in the current era of targeted therapies. Objective.—To highlight morphologic mimics of clear cell renal cell carcinoma and provide strategies to help differentiate clear cell renal cell carcinoma from other renal tumors and lesions. The role of the pathologist in guiding treatment for renal malignancies will be emphasized to stress the importance of proper tumor classification in patient management. Data Sources.—Published literature and personal experience. Conclusions.—In challenging cases, submission of additional tissue is often an inexpensive and effective way to facilitate a correct diagnosis. If immunohistochemical stains are to be used, it is best to use a panel of markers, as no one marker is specific for a given renal tumor subtype. Selection of limited markers, based on a specific differential diagnosis, can be as useful as a large panel in reaching a definitive diagnosis. For renal tumors, both the presence and absence of immunoreactivity and the pattern of labeling (membranous, cytoplasmic, diffuse, focal) are important when interpreting the results of immunohistochemical stains.

Value of Triphasic MDCT in the Differentiation of Small Renal Cell Carcinoma and Oncocytoma

2017 ◽  
Vol 84 (4) ◽  
pp. 244-250
Author(s):  
Michele Scialpi ◽  
Eugenio Martorana ◽  
Valeria Rondoni ◽  
Ahmed Eissa ◽  
Ahmed El Sherbiny ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Renal Clear Cell Carcinoma ◽  
Renal Tumors ◽  
Renal Oncocytoma ◽  
Multidetector Row Computed Tomography ◽  
Computed Tomographic ◽  
Unenhanced Ct ◽  
Significant Difference ◽  
Upper Abdomen

Introduction Although differentiation between benign and malignant small renal tumors (≤4 cm) is still difficult, it is a demand for decision making and determining the treatment strategy. Our aim is to evaluate the role of multidetector row computed tomography (MDCT) in the differentiation of small renal clear cell carcinoma (RCC) and renal oncocytoma (RO). Methods We reviewed triphasic computed tomographic (CT) scans performed in 43 patients diagnosed with RCC (n = 23) and RO (n = 21). After an unenhanced CT phase of the upper abdomen, triple-phase acquisition included a cortico-medullary phase (CMP), a nephrographic phase (NP), and a pyelographic phase (PP), and lesions were evaluated both qualitatively and quantitatively. Results RCCs were hypervascular in 13 cases and hypovascular in 10 cases, while ROs were hypervascular in nine cases and hypovascular in 12 cases. Mean attenuation values (MAVs) for hypervascular RCCs and hypervascular ROs on unenhanced examination were 34.0 ± 7.1 and 31.3 ± 8.1 HU, respectively. Enhancement in CMP was 173.1 ± 45.2 HU for RCCs and 151.1 ± 36.0 HU for ROs and a gradual wash-out in NP (148.8 ± 34.3 and 137.1 ± 33.9 HU for RCCs and ROs, respectively) and in PP (98.2 ± 36.0 HU for RCCs and 79.4 ± 21.5 HU for ROs) was observed. MAV for hypovascular RCCs and hypovascular ROs on unenhanced examination were 32.4 ± 12.0 and 28.9 ± 8.0 HU, respectively. Both hypovascular RCCs and ROs showed a statistically significant difference in each post contrastographic phase. Conclusions Absolute attenuation and the quantitative amount of the enhancement were not strong predictors for RO and RCC differentiation.

A Composite Renal Tumor: Metanephric Adenofibroma, Wilms Tumor, and Renal Cell Carcinoma: A Missing Link?

2012 ◽  
Vol 15 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Maria Laura Galluzzo ◽  
Maria T. Garcia de Davila ◽  
Gordan M. Vujanić
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Tumor ◽  
Wilms Tumor ◽  
Papillary Renal Cell Carcinoma ◽  
Renal Tumors ◽  
Metanephric Adenoma ◽  
Missing Link ◽  
Additional Support

A coexistence of different renal tumors has rarely been reported. The most commonly described association is of Wilms tumor and renal cell carcinoma. Metanephric adenofibroma has also been associated with Wilms tumor or papillary renal cell carcinoma. Another reported association is metanephric adenoma and papillary renal cell carcinoma with sarcomatoid dedifferentiation. Herein we describe a complex renal tumor containing areas of metanephric adenofibroma, Wilms tumor, and undifferentiated renal cell carcinoma in a previously healthy 18-year-old boy. The tumor showed histologic and immunohistochemical features of these 3 different tumors, offering additional support to the view that these 3 tumors are related.

scholarly journals Modern Pathologic Diagnosis of Renal Oncocytoma

2017 ◽  
Vol 4 (4) ◽  
pp. 1-12 ◽  
Author(s):  
Sara E Wobker ◽  
Sean R Williamson
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Tumor ◽  
Renal Oncocytoma ◽  
Advanced Imaging ◽  
Central Scar ◽  
Pathologic Diagnosis ◽  
Current State ◽  
Renal Mass Biopsy

Oncocytoma is a well-defined benign renal tumor, with classic gross and histologic features, including a tan or mahogany-colored mass with central scar, microscopic nested architecture, bland cytology, and round, regular nuclei with prominent central nucleoli. As a result of variations in this classic appearance, difficulty in standardizing diagnostic criteria, and entities that mimic oncocytoma, such as eosinophilic variant chromophobe renal cell carcinoma and succinate dehydrogenase-deficient renal cell carcinoma, pathologic diagnosis remains a challenge. This review addresses the current state of pathologic diagnosis of oncocytoma, with emphasis on modern diagnostic markers, areas of controversy, and emerging techniques for less invasive diagnosis, including renal mass biopsy and advanced imaging.

Temporal Change in Risk of Metachronous Contralateral Renal Cell Carcinoma: Influence of Tumor Characteristics and Demographic Factors

2002 ◽  
Vol 20 (9) ◽  
pp. 2370-2375 ◽  
Author(s):  
Farhang Rabbani ◽  
Harry W. Herr ◽  
Taghreed Almahmeed ◽  
Paul Russo
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Tumor ◽  
Demographic Factors ◽  
White Men ◽  
Initial Diagnosis ◽  
Renal Tumors ◽  
Tumor Characteristics

PURPOSE: To determine the relative risk (RR) of developing a metachronous contralateral renal tumor after an initial diagnosis of renal cell carcinoma (RCC), with stratification by renal tumor characteristics, demographic factors, and follow-up duration, in order to develop an improved risk-based surveillance strategy. PATIENTS AND METHODS: The 1973 to 1997 Surveillance, Epidemiology, and End Results database was used to determine the observed and expected number of metachronous contralateral renal tumors developing after an initial diagnosis of RCC. RESULTS: A total of 43,483 patients had a first diagnosis of RCC. Contralateral RCC developed subsequently in 155 (0.4%) of 40,049 patients with follow-up who had no synchronous diagnosis of RCC, with 10.81 expected cases (RR, 14.3; 95% CI, 12.2 to 16.8). The respective RRs (and 95% CIs) for contralateral RCC for white men and women were 16.0 (11.1 to 22.3) and 13.7 (7.7 to 22.6) at less than 2 years, 8.8 (5.0 to 14.3) and 10.5 (5.0 to 19.3) at 2 to 5 years, 13.5 (8.1 to 21.0) and 5.1 (1.4 to 13.2) at 5 to 10 years, and 13.0 (6.2 to 23.9) and 13.7 (5.0 to 29.9) at ≥ 10 years, respectively. The RRs were significantly higher in black compared with white men for the first 5 years, with the RRs (and 95% CIs) in the former group of 95.3 (58.2 to 146.7) at less than 2 years and 41.9 (16.8 to 86.3) at 2 to 5 years. CONCLUSION: The incidence of metachronous contralateral RCC is stable on long-term follow-up, suggesting that surveillance of the contralateral kidney should remain rigorous on extended follow-up. Black men are at a significantly higher risk of developing contralateral RCC in the first 5 years of follow-up.

scholarly journals Eyelid Metastasis as the Initial Presentation of a Renal Cell Carcinoma: a Case Report and Review of the Literature.

2021 ◽  
Author(s):  
QiXiang Fang ◽  
Na Xie ◽  
Wei Chen ◽  
Guodong Zhu ◽  
Jin Zeng ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Left Lung ◽  
Renal Clear Cell Carcinoma ◽  
Initial Presentation ◽  
Renal Tumors

Abstract Introduction: Renal clear cell carcinoma(ccRCC) accounts for about 85% of patients with renal carcinoma and is the most common pathological type of renal cancer. Renal clear cell carcinomas usually metastasize to the lungs, lymph nodes, liver, bones, and brain, with rare skin metastases, especially to the eyelids. In this study, we report the third current case of renal clear cell carcinoma with eyelid mass as its initial presentation.Case presentation: In this study, we describe in detail the case of a 62-year-old male patient with clear cell carcinoma of the kidney whose first symptom was a mass of the right eyelid. The patient had no clinical manifestations other than eyelid mass before the diagnosis of renal clear cell carcinoma. After resection of eyelid mass, postoperative pathological and immunohistochemical studies showed clear cell carcinoma of the kidney. Subsequently, a computed tomography scan disclosed bilateral renal tumors, bilateral adrenal nodules, and nodules in the upper lobe of the left lung. At the time of writing, the patient was receiving sunitinib treatment and receiving regular outpatient follow-up. Discussion and conclusion: Metastasis of renal carcinoma to the eye is rare, especially with an eyelid mass as the initial presentation. If they occur before the diagnosis of cancer or years after nephrectomy, the diagnosis of the tumor may be missed. In this study, we report the rare case and review reports of renal cell carcinoma metastasizing to the eye to raise our awareness of this rare phenomenon.

scholarly journals Tubulocystic Renal Cell Carcinoma: A Rare Renal Tumor

2014 ◽  
Vol 1 (5) ◽  
pp. 56-62 ◽  
Author(s):  
Jasneet Singh Bhullar ◽  
Sandiya Bindroo ◽  
Neha Varshney ◽  
Vijay Mittal
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Tumor ◽  
Renal Tumors ◽  
Extensive Literature ◽  
Vancouver Classification ◽  
Distinct Entity ◽  
Extensive Literature Search

Tubulocystic renal cell carcinoma of the kidney is a rare entity with less than one hundred cases reported so far. It was previously considered to have some similarities to various other renal cancers although this tumor has distinct macroscopic, microscopic and immuno-histochemical features. It is now a well-established entity in renal neoplastic pathology and has been recognized as a distinct entity in the 2012 Vancouver classification of renal tumors. This review aims to give an overview of tubulocystic renal cell carcinoma after extensive literature search using PubMed and CrossRef. 

scholarly journals Renal artery aneurysm misdiagnosed as renal cell carcinoma

2020 ◽  
Vol 7 (4) ◽  
pp. 1296
Author(s):  
Shashi . ◽  
Rajdeep Singh ◽  
Manu Vats
Keyword(s):  
Renal Cell Carcinoma ◽  
Renal Artery ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Tumor ◽  
Artery Aneurysm ◽  
Renal Tumors ◽  
Renal Artery Aneurysm ◽  
Suspicious Lesion ◽  
Management Protocol

Renal tumors are best diagnosed by contrast-enhanced computed tomography (CECT) abdomen along with history and physical examination. In case of suspicious lesions in respect to location like lesion arising from the bifurcation of renal artery and close to major vessels with all features suggesting of tumor with absent contrast enhancement and absent color flow on Doppler study should be further investigated keeping other possibility of Renal artery aneurysm with thrombus mimicking as renal tumor. CT angiography should be done in every case of suspicious lesion because this will change the further management protocol from Nephrectomy in case of renal tumor to kidney preserving minimally invasive procedure for renal artery aneurysm. Like in this case diagnosis of Renal cell carcinoma was made on the basis of CECT abdomen findings and managed further as per the management protocol for renal tumor but intraoperatively found renal artery aneurysm. On conclusion every suspicious lesion of kidney should be further investigated for renal artery aneurysm so that kidney preserving procedure could be planned preoperatively.

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