scholarly journals High-Grade Carcinomas Involving the Renal Sinus: Report of a Case and Review of the Differential Diagnosis and Immunohistochemical Expression

2012 ◽  
Vol 136 (8) ◽  
pp. 907-910 ◽  
Author(s):  
Allison Young ◽  
Lakshmi P. Kunju
Keyword(s):  
Renal Cell Carcinoma ◽  
Differential Diagnosis ◽  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Collecting Duct ◽  
Upper Urinary Tract ◽  
High Grade ◽  
Renal Sinus

We report the case of a high-grade carcinoma involving the kidney in a young male with renal vein thrombosis and review the differential diagnosis and immunohistochemical workup. High-grade neoplasms involving the renal sinus include collecting duct carcinomas (CDCs), renal medullary carcinomas (RMCs), invasive high-grade urothelial carcinoma (UC) of the upper urinary tract, clear cell renal cell carcinoma, and type 2 papillary renal cell carcinoma. Distinguishing UC from CDC and RMC is problematic in small biopsy samples. The diagnosis of CDC (a rare, aggressive subtype of renal cell carcinoma) is challenging and requires the exclusion of UC. Renal medullary carcinoma is characterized by an appropriate clinical setting and consistent loss of nuclear expression of integrase interactor 1 (INI-1). A panel consisting of p63, paired box gene 8 (PAX8), and INI-1 is most optimal in distinguishing UC from CDC and RMC. A subset of urothelial carcinoma of upper urinary tract may be positive with PAX8.

scholarly journals A DNA adductome analysis revealed a reduction in the global level of C5-hydroxymethyl-2′-deoxycytidine in the non-tumoral upper urinary tract mucosa of urothelial carcinoma patients

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Yuto Matsushita ◽  
Yuji Iwashita ◽  
Shunsuke Ohtsuka ◽  
Ippei Ohnishi ◽  
Takashi Yamashita ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Dna Adducts ◽  
Renal Pelvis ◽  
Renal Cell ◽  
Renal Cortex ◽  
Upper Urinary Tract ◽  
Urinary Tract Urothelial Carcinoma

Abstract Background DNA adducts, covalent modifications to DNA due to exposure to specific carcinogens, cause the mispairing of DNA bases, which ultimately results in DNA mutations. DNA methylation in the promoter region, another type of DNA base modification, alters the DNA transcription process, and has been implicated in carcinogenesis in humans due to the down-regulation of tumor suppressor genes. Difficulties are associated with demonstrating the existence of DNA adducts or chemically modified bases in the human urological system. Apart from aristolochic acid-DNA adducts, which cause urothelial carcinoma and endemic nephropathy in a particular geographical area (Balkan), limited information is currently available on DNA adduct profiles in renal cell carcinoma and upper urinary tract urothelial carcinoma, including renal pelvic cancer and ureteral cancer. Method To elucidate the significance of DNA adducts in carcinogenesis in the urothelial system, we investigated 53 DNA adducts in the non-tumoral renal parenchyma and non-tumoral renal pelvis of patients with renal cell carcinoma, upper urinary tract urothelial carcinoma, and other diseases using liquid chromatography coupled with tandem mass spectrometry. A comparative analysis of tissue types, the status of malignancy, and clinical characteristics, including lifestyle factors, was performed. Results C5-Methyl-2′-deoxycytidine, C5-hydroxymethyl-2′-deoxycytidine (5hmdC), C5-formyl-2′-deoxycytidine, 2′-deoxyinosine, C8-oxo-2′-deoxyadenosine, and C8-oxo-2′-deoxyguanosine (8-OHdG) were detected in the renal parenchyma and renal pelvis. 8-OHdG was more frequently detected in the renal pelvis than in the renal cortex and medulla (p = 0.048 and p = 0.038, respectively). 5hmdC levels were significantly lower in the renal pelvis of urothelial carcinoma patients (n = 10) than in the urothelium of patients without urothelial carcinoma (n = 15) (p = 0.010). Regarding 5hmdC levels in the renal cortex and medulla, Spearman’s rank correlation test revealed a negative correlation between age and 5hmdC levels (r = − 0.46, p = 0.018 and r = − 0.45, p = 0.042, respectively). Conclusions The present results revealed a reduction of 5hmdC levels in the non-tumoral urinary tract mucosa of patients with upper urinary tract urothelial carcinoma. Therefore, the urothelial cell epithelia of patients with upper urinary tract cancer, even in non-cancerous areas, may be predisposed to urothelial cancer.

scholarly journals The Differential Diagnosis of Medullary-Based Renal Masses

2021 ◽  
Author(s):  
Nicholas Baniak ◽  
Harrison Tsai ◽  
Michelle S. Hirsch
Keyword(s):  
Renal Cell Carcinoma ◽  
Differential Diagnosis ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Collecting Duct ◽  
Fumarate Hydratase ◽  
Growth Patterns ◽  
Renal Tumors ◽  
Renal Masses ◽  
Duct Carcinoma

Context.— Renal malignancies can be divided into cortical- and medullary-based tumors, the latter of which classically infiltrate the renal parenchyma by extending between nonneoplastic structures. Although high-grade cortical tumors can rarely exhibit the same growth pattern, the infiltrative morphology should elicit a differential diagnosis to be considered in each case. However, these diagnoses can be challenging to distinguish, especially on small renal biopsy samples. Objective.— To provide an overview of the clinical, gross, and microscopic findings; genetic and molecular alterations; and immunohistochemical evaluation of medullary-based renal tumors and other tumor types with overlapping morphologies and growth patterns. Data Sources.— Literature review and personal observations were used to compile the information in this review. Conclusions.— Collecting duct carcinoma is a prototypical medullary-based tumor, and although diagnostic criteria exist, it remains a diagnosis of exclusion, especially with ancillary techniques aiding the recognition of established as well as more recently described neoplasms. Other medullary-based malignancies included in the differential diagnosis include renal medullary carcinoma/renal cell carcinoma unclassified with medullary phenotype, fumarate hydratase–deficient renal cell carcinoma, and upper tract urothelial carcinoma. Moreover, other rare entities should be excluded, including metastatic carcinoma, lymphoma, and melanoma. In addition to potential prognostic differences, accurate diagnoses can have important surgical and clinical management implications.

scholarly journals Renal Cell Carcinoma with Intraluminal Spread of the Entire Upper Urinary Tract

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Shigenori Kakutani ◽  
Haruki Kume ◽  
Yoshikazu Hirano ◽  
Toshihiko Wakita ◽  
Yukio Homma
Keyword(s):  
Computed Tomography ◽  
Renal Cell Carcinoma ◽  
Urinary Tract ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Unusual Case ◽  
Clear Cell ◽  
Renal Tumor ◽  
Upper Urinary Tract ◽  
Macroscopic Hematuria

We describe an unusual case of renal cell carcinoma (RCC) involving the entire upper urinary tract. A 51-year-old female was referred to us because of macroscopic hematuria. Computed tomography revealed a renal tumor filling renal pelvis and ureter, which turned to be a clear cell RCC after nephroureterectomy.

scholarly journals Renal Cell Carcinoma with Clear Cell Papillary Features: Perspectives of a Differential Diagnosis

2019 ◽  
Vol 26 (3) ◽  
pp. 1767-1776 ◽  
Author(s):  
Áron Somorácz ◽  
Levente Kuthi ◽  
Tamás Micsik ◽  
Alex Jenei ◽  
Adrienn Hajdu ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Differential Diagnosis ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Cyst Formation ◽  
Low Grade ◽  
Renal Sinus ◽  
Chromosome 3P ◽  
Papillary Rcc

Abstract Thirty-one cases of low-grade renal cell carcinoma (RCC) with clear cells and tubulopapillary/papillary architecture were analyzed retrospectively with immunohistochemical and genetic markers to gain more experience with the differential diagnosis of such cases. All samples coexpressed CK7 and CA9; the TFE3 or TFEB reactions were negative; the CD10 and the AMACR stainings were negative in 27 cases and 30 cases, respectively. The FISH assays for papillary RCC, available in 27 cases, and deletion of chromosome 3p, available in 29 cases, gave negative results. The results for 3p deletion, VHL gene mutation or VHL gene promoter region hypermethylation testing, along with the diffuse CD10-positivity in 2 cases confirmed 21 cases as clear cell papillary RCC (CCPRCC; CK7+, CA9+; no 3p loss, no VHL abnormality) and 10 cases as clear cell RCC (CCRCC; CK7+, CA9+; no 3p loss, VHL abnormality mutation/hypermethylation present). In CCPRCCs, the representative growth pattern was branching tubulo-acinar, commonly accompanied by cyst formation. The linear nuclear arrangement or cup-shaped staining of CA9 did not necessarily indicate CCPRCC, and the absence of these did not exclude the diagnosis of CCPPRC. One tumor infiltrated the renal sinus; the others exhibited pT1 stage; and metastatic outcome was not recorded. The CCRCC cases were in pT1 stage; 6 exhibited cup-shaped staining of CA9, and 1 displayed lymph node metastasis at the time of surgery. Distant metastatic disease was not observed. In summary, the VHL abnormalities distinguished the subset of CCRCC with diffuse CK7-positivity and no 3p loss from cases of CCPRCC.

scholarly journals Cooccurrence of Multilocular Cystic Renal Cell Carcinoma and High-Grade Urothelial Carcinoma in Bladder

2014 ◽  
Vol 5 (11) ◽  
pp. 610-612
Author(s):  
Seyma Ozkanli ◽  
Elvan Atsatan Turfanda ◽  
Tulay Zenginkinet ◽  
Abdullah Aydin
Keyword(s):  
Renal Cell Carcinoma ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
High Grade ◽  
Cystic Renal Cell Carcinoma

scholarly journals P63 Immunoreactivity Distinguishes Upper Urinary Tract Transitional-cell Carcinoma and Renal-cell Carcinoma Even in Poorly Differentiated Tumors

2003 ◽  
Vol 51 (8) ◽  
pp. 1097-1099 ◽  
Author(s):  
Cord Langner ◽  
Manfred Ratschek ◽  
Oleksiy Tsybrovskyy ◽  
Luigi Schips ◽  
Richard Zigeuner
Keyword(s):  
Renal Cell Carcinoma ◽  
Urinary Tract ◽  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Transitional Cell ◽  
Upper Urinary Tract ◽  
High Stage ◽  
Poorly Differentiated ◽  
Microarray Technique

P63 is essential for the differentiation of normal urothelium and is also expressed in transitional cell carcinoma (TCC) of the bladder. We investigated p63 immunoreactivity in upper urinary tract TCC ( n = 53) and in renal-cell carcinoma (RCC; n = 188) using a tissue microarray technique. P63 expression was detected in 51/53 (96.2%) TCCs, showing decreased expression in high-stage (pT1 and pT2 100%; pT3 90.9%) and poorly differentiated (G1 and G2 100%; G3 92%) tumors. All RCCs were negative for p63. P63 proved to be a helpful tool, even in poorly differentiated and undifferentiated renal malignancies, to distinguish TCC from RCC.

scholarly journals Renal epithelioid angiomyolipoma mimicking urothelial carcinoma of the upper urinary tract

2014 ◽  
Vol 86 (3) ◽  
pp. 235 ◽  
Author(s):  
Senol Adanur ◽  
Ercüment Keskin ◽  
Tevfik Ziypak ◽  
Erdem Koc ◽  
Elif Demirci ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Urinary Tract ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Carcinoma ◽  
Left Kidney ◽  
Upper Urinary Tract ◽  
Urothelial Cell Carcinoma ◽  
Epithelioid Angiomyolipoma ◽  
Sarcomatoid Renal Cell Carcinoma

Epithelioid angiomyolipoma is a rare mesenchymal tumor arising mainly in the kidney that can potentially behave aggressively. Epithelioid angiomyolipoma can often resemble sarcomatoid renal cell carcinoma, high grade renal carcinoma or sarcoma. Its similarity to renal cell carcinoma has been emphasized in most of the cases reported in literature. With the purpose of contributing to the awareness of this similarity, a 32-year-old female patient with renal epitelioid angiomyolipoma in the left kidney which radiologically mimicked urothelial cell carcinoma of the upper urinary tract is presented.

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