scholarly journals Diagnostic Approach to Eosinophilic Renal Neoplasms

2014 ◽  
Vol 138 (11) ◽  
pp. 1531-1541 ◽  
Author(s):  
Oleksandr N. Kryvenko ◽  
Merce Jorda ◽  
Pedram Argani ◽  
Jonathan I. Epstein
Keyword(s):  
Transcription Factor ◽  
Renal Cell ◽  
Diagnostic Approach ◽  
Low Grade ◽  
Renal Neoplasms ◽  
Cytokeratin 7 ◽  
Epithelioid Angiomyolipoma ◽  
Papillary Rcc ◽  
Microphthalmia Transcription Factor ◽  
Hereditary Leiomyomatosis

Context Eosinophilic renal neoplasms include a spectrum of solid and papillary tumors ranging from indolent benign oncocytoma to highly aggressive malignancies. Recognition of the correct nature of the tumor, especially in biopsy specimens, is paramount for patient management. Objective To review the diagnostic approach to eosinophilic renal neoplasms with light microscopy and ancillary techniques. Data Sources Review of the published literature and personal experience. Conclusions The following tumors are in the differential diagnosis of oncocytic renal cell neoplasm: oncocytoma, chromophobe renal cell carcinoma (RCC), hybrid tumor, tubulocystic carcinoma, papillary RCC, clear cell RCC with predominant eosinophilic cell morphology, follicular thyroid-like RCC, hereditary leiomyomatosis–associated RCC, acquired cystic disease–associated RCC, rhabdoid RCC, microphthalmia transcription factor translocation RCC, epithelioid angiomyolipoma, and unclassified RCC. In low-grade nonpapillary eosinophilic neoplasms, distinction between oncocytoma and low-grade RCC mostly rests on histomorphology; however, cytokeratin 7 immunostain may be helpful. In high-grade nonpapillary lesions, there is more of a role for ancillary techniques, including immunohistochemistry for cytokeratin 7, CA9, CD10, racemase, HMB45, and Melan-A. In papillary eosinophilic neoplasms, it is important to distinguish sporadic type 2 papillary RCC from microphthalmia transcription factor translocation and hereditary leiomyomatosis–associated RCC. Histologic and cytologic features along with immunohistochemistry and fluorescence in situ hybridization tests for TFE3 (Xp11.2) and TFEB [t(6;11)] are reliable confirmatory tests. Eosinophilic epithelial neoplasms with architecture, cytology, and/or immunoprofile not qualifying for either of the established types of RCC should be classified as unclassified eosinophilic RCC and arbitrarily assigned a grade (low or high).

scholarly journals Papillary renal cell carcinoma within a renal oncocytoma: Case report of very rare coexistence

2014 ◽  
Vol 8 (11-12) ◽  
pp. 928 ◽  
Author(s):  
Cevahir Özer ◽  
Mehmet Resit Gören ◽  
Tulga Egilmez ◽  
Nebil Bal
Keyword(s):  
Renal Cell Carcinoma ◽  
Case Report ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Papillary Renal Cell Carcinoma ◽  
Renal Oncocytoma ◽  
Renal Neoplasms ◽  
Renal Oncocytomas ◽  
Papillary Rcc

Renal oncocytomas accounts for 3% to 9% of primary renal neoplasms. The coexistence of renal cell carcinoma (RCC) within the oncocytoma is extremely rare. We report the case of an asymptomatic 74-year-old man with papillary RCC within oncocytoma managed with left radical nephrectomy.

Translocation Renal Cell Carcinomas: An Evolving Entity and a Member of the Microphthalmia Transcription Factor-Associated Family of Tumors

2013 ◽  
Vol 11 (3) ◽  
pp. 357-361 ◽  
Author(s):  
Richard M. Bambury ◽  
Jodie E. Battley ◽  
Aoife McCarthy ◽  
Claire Brady ◽  
Seamus O'Reilly ◽  
...  
Keyword(s):  
Transcription Factor ◽  
Renal Cell ◽  
Renal Cell Carcinomas ◽  
Microphthalmia Transcription Factor ◽  
Associated Family

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.

Expression of Galectin-3 in Renal Neoplasms: A Diagnostic, Possible Prognostic Marker

2010 ◽  
Vol 134 (1) ◽  
pp. 90-94
Author(s):  
Jane Y. Dancer ◽  
Luan D. Truong ◽  
Qihui Zhai ◽  
Steven S. Shen
Keyword(s):  
Renal Cell ◽  
Clear Cell ◽  
Strong Association ◽  
Prognostic Significance ◽  
Low Grade ◽  
Renal Neoplasms ◽  
Galectin 3 ◽  
Lectin Family ◽  
Clear Cell Rccs ◽  
Clear Cell Rcc

Abstract Context. Galectin-3, a member of the lectin family, was shown to be expressed in normal distal tubular cells and in renal cell carcinomas (RCC). However, its diagnostic and prognostic significance in RCC is as yet undefined. Objectives. To describe the expression of Galectin-3 among different histologic subtypes of renal neoplasms and to determine their diagnostic and prognostic significances. Design. The expression of Galectin-3 was evaluated in 217 renal neoplasms by tissue microarray and immunohistochemistry with semiquantitative analysis. Results. Strong expression of Galectin-3 was observed in 92 of 217 of renal neoplasms (42.4%). Although 22 of 23 oncocytomas (95.7%) and 19 of 21 chromophobe RCCs (90.5%) express Galectin-3, only 4 of 32 papillary RCCs (12.5%) and 47 of 137 clear cell RCCs (34.3%) express Galectin-3, suggesting that it may be used as a potential diagnostic marker. Galectin-3 expression was seen in 55% of high-grade (Fuhrman nuclear grades 3 and 4) versus 21% low-grade (grades 1 and 2) clear cell RCCs (P < .001). Conclusions. This study confirms that Galactin-3 is strongly overexpressed in renal cell neoplasms of distal tubular differentiation, that is, oncocytoma and chromophobe RCCs, suggesting it might be used as a possible differential diagnostic tool for renal cell neoplasm with oncocytic or granular cells. Furthermore, we observed a strong association of overexpression of Galectin-3 and high nuclear grade in clear cell RCC. These results also suggest a possible pivotal role for Galectin-3 in the differentiation and prognosis of clear cell RCC.

Diffusion kurtosis imaging features of renal cell carcinoma: a preliminary study

2021 ◽  
pp. 20201374
Author(s):  
Qingqiang Zhu ◽  
Qing Xu ◽  
Weiqiang Dou ◽  
Wenrong Zhu ◽  
Jingtao Wu ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Diffusion Kurtosis Imaging ◽  
Low Grade ◽  
B Values ◽  
Chromophobe Rcc ◽  
Preliminary Study ◽  
Papillary Rcc ◽  
Diffusion Kurtosis

Objective: To explore the feasibility of diffusion kurtosis imaging (DKI) in differentiating different types of renal cell carcinoma (RCC). Methods: 36 patients with clear cell RCC (CCRCC, low-grade,n = 20 and high-grade, n = 16), 19 with papillary RCC, 11 with chromophobe RCC, and 9 with collecting duct carcinoma (CDC) were examined with DKI technique. b values of 0, 500 and 1000 s/mm2 were adopted. The DKI parameters, i.e., mean diffusivity (MD), mean kurtosis (MK), kurtosis anisotropy (KA), radial kurtosis (RK) and signa-to-noise ration (SNR) of DKI images at different b values were used. Results: The mean SNRs of DKI images at b = 0, 500 and 1000 s/mm2 were 32.8, 14.2 and 9.18, respectively. For MD parameter, a significant higher value was shown in CCRCC than those of papillary RCC, chromophobe RCC and CDC (p < 0.05). In addition, both chromophobe RCC and CDC have larger MD values than papillary RCC (p < 0.05), however, there was no significant differences between chromophobe RCC and CDC (p > 0.05). For MK, KA and RK parameters, a significant higher value was shown in papillary RCC than those of CCRCC, chromophobe RCC and CDC (p < 0.05). Moreover, both chromophobe RCC and CDC have significantly larger values of MK, KA and RK than CCRCC (p < 0.05). Conclusion: Our preliminary study demonstrated significant differences in the DKI parameters between the subtypes of RCCs, given an adequate SNR of DKI images. Advances in knowledge: 1.The MD value is the best parameter to distinguish CCRCC from other RCCs. 2.The MK, KA and RK values are the best parameters to distinguish papillary RCC from other RCCs. 3.DKI is able to provide images with sufficient SNRs in kidney disease.

Low-grade oncocytic tumour of kidney (CD117-negative, cytokeratin 7-positive)

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Cláudio Galeno Ramalho de Andrade Melo ◽  
Marcus Vinicius Nunes Xavier ◽  
Isabela Soares Pimenta ◽  
Daniel Abensur Athanazio
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Left Kidney ◽  
Diagnostic Category ◽  
Growth Patterns ◽  
Low Grade ◽  
Cytokeratin 7 ◽  
Case Presentation ◽  
Stromal Edema

Abstract Background The term low-grade oncocytic tumour of kidney is an emerging entity describing CD117-negative and cytokeratin 7-positive indolent tumors with overlapping morphological features between oncocytic tumors. Case presentation We present herein the case of a 77-year-old female with a 3.2-cm nodule in mid pole of the left kidney. The tumor was uniformly oncocytic with solid, compact nested and trabecular growth patterns. There was common areas of transition to central zones of stromal edema with marked tumor hypocellularity and growth in cords. Some of these areas had adjacent fresh hemorrhage. Immunohistochemistry showed strong and diffuse expression of cytokeratin 7 and negativity for cKIT/CD117. Conclusion The proper use of this new diagnostic category avoids labeling such tumors as unclassified renal cell carcinoma – a broad category with different morphologic features and heterogenous prognosis.

Clinical characteristics and treatments of hereditary leiomyomatosis renal cell carcinoma: two case reports and literature review

2020 ◽  
Author(s):  
Dalin Feng ◽  
Mingshuai Wang ◽  
Xiaodong Zhang ◽  
Jianwen Wang
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Female Patient ◽  
Male Patient ◽  
Renal Cell ◽  
Clinical Characteristics ◽  
Genetic Test ◽  
Enhanced Ct ◽  
The Right ◽  
Hereditary Leiomyomatosis

Abstract Background The objective of this study is to discuss clinical characteristics and treatments of hereditary leiomyomatosis renal cell carcinoma on the basis of 2 cases and to review recent literature, in order to present medical advances. Methods A 29-year old male patient came to our hospital because of a huge tumour on the right kidney. Enhanced CT showed that the tumour was about 15.5*10.5 cm, and was considered to be malignant. Another case was a 38-year old female patient. She complained was found to have a right kidney tumour in a routine physical examination. Enhanced CT showed an early-stage tumour of about 4.3*3.7 cm on the lower pole of the right kidney. The male patient underwent open radical nephrectomy and the female patient underwent laparoscopic radical nephrectomy and extensive retroperitoneal lymph node dissection. The two patients underwent genetic testing and were diagnosed as having hereditary leiomyomatosis with renal cell carcinoma. Results The postoperative pathology in both patients revealed type 2 papillary renal cell carcinoma but with different prognosis. The male patient suffered multiple metastasis 10 months post-operation. The metastatic tumour of the abdominal wall was resected to confirm recurrence and hereditary leiomyomatosis renal cell carcinoma was diagnosed by the genetic test. While the female patient had a specific family history and uterine leiomyomas, the genetic test helped us to identify hereditary leiomyomatosis renal cell carcinoma pre-operation. Because of the early diagnosis and timely treatment, the female patient was considered to have a good prognosis. Conclusion Hereditary leiomyomatosis renal cell carcinoma is a rare hereditary disease resulting from FH gene mutation. There are currently no effective treatments.Our cases demonstrate that hereditary leiomyomatosis renal cell carcinoma is a very aggressive disease. Early screening and surveillance are recommended for patients with a family history or who are at risk of hereditary leiomyomatosis renal cell carcinoma. Surgical and palliative therapy still play an important role in clinical treatment.

scholarly journals Cathepsin K: A Novel Diagnostic and Predictive Biomarker for Renal Tumors

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2441
Author(s):  
Anna Caliò ◽  
Matteo Brunelli ◽  
Stefano Gobbo ◽  
Pedram Argani ◽  
Enrico Munari ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Therapy Response ◽  
Cathepsin K ◽  
Mtor Inhibitors ◽  
Predictive Marker ◽  
Predictive Biomarker ◽  
Renal Tumors ◽  
Epithelioid Angiomyolipoma

Cathepsin K is a papain-like cysteine protease with high matrix-degrading activity. Among several cathepsins, cathepsin K is the most potent mammalian collagenase, mainly expressed by osteoclasts. This review summarizes most of the recent findings of cathepsin K expression, highlighting its role in renal tumors for diagnostic purposes and as a potential molecular target. Indeed, cathepsin K is a recognized diagnostic tool for the identification of TFE3/TFEB-rearranged renal cell carcinoma, TFEB-amplified renal cell carcinoma, and pure epithelioid PEComa/epithelioid angiomyolipoma. More recently, its expression has been observed in a subgroup of eosinophilic renal neoplasms molecularly characterized by TSC/mTOR gene mutations. Interestingly, both TSC mutations or TFE3 rearrangement have been reported in pure epithelioid PEComa/epithelioid angiomyolipoma. Therefore, cathepsin K seems to be a downstream marker of TFE3/TFEB rearrangement, TFEB amplification, and mTOR pathway activation. Given the established role of mTOR inhibitors as a pharmacological option in renal cancers, cathepsin K could be of use as a predictive marker of therapy response and as a potential target. In the future, uropathologists may implement the use of cathepsin K to establish a diagnosis among renal tumors with clear cells, papillary architecture, and oncocytic features.

scholarly journals Identification of miR-20a-5p as Robust Normalizer for Urine microRNA Studies in Renal Cell Carcinoma and A Profile of Dysregulated microRNAs

2021 ◽  
Vol 22 (15) ◽  
pp. 7913
Author(s):  
Julia Oto ◽  
Raquel Herranz ◽  
Emma Plana ◽  
José Vicente Sánchez-González ◽  
Javier Pérez-Ardavín ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Diagnostic Value ◽  
Diagnostic Model ◽  
Low Grade ◽  
Non Invasive ◽  
Good Expression ◽  
Independent Cohort

Renal cell carcinoma (RCC) is the third most frequent urinary malignancy and one of the most lethal. Current diagnostic and follow-up techniques are harmful and unspecific in low-grade tumors. Novel minimally invasive markers such as urine microRNAs (miRNAs) are under study. However, discrepancies arise among studies in part due to lack of consent regarding normalization. We aimed to identify the best miRNA normalizer for RCC studies performed in urine samples together with a miRNA profile with diagnostic value and another for follow-up. We evaluated the performance of 120 candidate miRNAs in the urine of 16 RCC patients and 16 healthy controls by RT-qPCR followed by a stability analysis with RefFinder. In this screening stage, miR-20a-5p arose as the most stably expressed miRNA in RCC and controls, with a good expression level. Its stability was validated in an independent cohort of 51 RCC patients and 32 controls. Using miR-20a-5p as normalizer, we adjusted and validated a diagnostic model for RCC with three miRNAs (miR-200a-3p, miR-34a-5p and miR-365a-3p) (AUC = 0.65; Confidence Interval 95% [0.51, 0.79], p = 0.043). let-7d-5p and miR-205-5p were also upregulated in patients compared to controls. Comparing RCC samples before surgery and fourteen weeks after, we identified let-7d-5p, miR-152-3p, miR-30c-5p, miR-362-3p and miR-30e-3p as potential follow-up profile for RCC. We identified validated targets of most miRNAs in the renal cell carcinoma pathway. This is the first study that identifies a robust normalizer for urine RCC miRNA studies, miR-20a-5p, which may allow the comparison of future studies among laboratories. Once confirmed in a larger independent cohort, the miRNAs profiles identified may improve the non-invasive diagnosis and follow-up of RCC.

Sign in / Sign up

Export Citation Format

Share Document