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Clear cell papillary renal cell carcinoma: a potential mimic of conventional clear cell renal carcinoma on core biopsy.

Liddell H, Mare A, Heywood S, Bennett G, Chan HF - Case Rep Urol (2015)

Bottom Line: Thought to only arise in those with end stage renal disease, CCP-RCC is increasingly identified in those without renal impairment.Immunohistochemically, these tumors are positive for CK7 and negative for CD10 and racemase.These tumours appear to be indolent in nature, with no current documented cases of metastatic spread.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, The Canberra Hospital, Garran, ACT 2605, Australia.

ABSTRACT
Clear cell papillary renal cell carcinoma (CCP-RCC) is a recently described, relatively uncommon variant of renal cell carcinoma (RCC) with a reported incidence of 4.1%. Thought to only arise in those with end stage renal disease, CCP-RCC is increasingly identified in those without renal impairment. CCP-RCCs have unique morphologic, genetic, and immunohistochemical features distinguishing them from both conventional clear cell renal cell carcinomas and papillary renal cell carcinomas. Immunohistochemically, these tumors are positive for CK7 and negative for CD10 and racemase. This is in contrast to conventional cell renal cell carcinomas (CK7 negative, CD10 positive) and papillary cell carcinomas (CK7, CD10, and racemase positive). These tumours appear to be indolent in nature, with no current documented cases of metastatic spread. We present the case of a 42-year-old female who presented with an incidental finding of a renal mass that on a core biopsy was reported as clear cell carcinoma, Fuhrman grade 1. She subsequently underwent a radical nephrectomy and further histological examination revealed the tumor to be a clear cell papillary renal cell carcinoma, Fuhrman grade 1.

No MeSH data available.


Related in: MedlinePlus

CK7 positive staining highlighting tubular and cystic architecture.
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fig4: CK7 positive staining highlighting tubular and cystic architecture.

Mentions: Histologically, these tumors consist of a single layer of cuboidal cells with clear cytoplasm arranged in tubular, cystic, and papillary patterns (Figure 2). Nuclei are typically separated from the base of the cell and the nuclear characteristics are such that all CCP-RCC are Fuhrman grade 1 or 2. Characteristically, the cells have subnuclear vacuoles, similar to the glands of early secretory phase endometrium. Another consistent finding is the presence of smooth muscle bundles within the tumour capsule and scattered throughout the body of the tumour (Figure 3). In contrast to clear cell carcinoma, these tumours are positive for CK7 and unlike papillary carcinoma, they are negative for CD10 and racemase (Figure 4). They do not exhibit gains of chromosome 7 or 17 nor loss of chromosome Y as seen in papillary renal cell carcinoma, nor do they exhibit loss of the chromosome 3p or VHL gene mutations as seen in clear cell carcinoma. They may contain areas with a striking resemblance to conventional clear cell renal cell carcinomas. Given this tumour heterogeneity, the potential for sampling error associated with a small core biopsy specimen means that caution should be exhibited when attempting to make a diagnosis of CCP-RCC on core biopsy. Radiologically, these tumors are indistinct from other renal cell carcinomas, appearing as a solid enhancing heterogenous mass following the administration of IV contrast.


Clear cell papillary renal cell carcinoma: a potential mimic of conventional clear cell renal carcinoma on core biopsy.

Liddell H, Mare A, Heywood S, Bennett G, Chan HF - Case Rep Urol (2015)

CK7 positive staining highlighting tubular and cystic architecture.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4325967&req=5

fig4: CK7 positive staining highlighting tubular and cystic architecture.
Mentions: Histologically, these tumors consist of a single layer of cuboidal cells with clear cytoplasm arranged in tubular, cystic, and papillary patterns (Figure 2). Nuclei are typically separated from the base of the cell and the nuclear characteristics are such that all CCP-RCC are Fuhrman grade 1 or 2. Characteristically, the cells have subnuclear vacuoles, similar to the glands of early secretory phase endometrium. Another consistent finding is the presence of smooth muscle bundles within the tumour capsule and scattered throughout the body of the tumour (Figure 3). In contrast to clear cell carcinoma, these tumours are positive for CK7 and unlike papillary carcinoma, they are negative for CD10 and racemase (Figure 4). They do not exhibit gains of chromosome 7 or 17 nor loss of chromosome Y as seen in papillary renal cell carcinoma, nor do they exhibit loss of the chromosome 3p or VHL gene mutations as seen in clear cell carcinoma. They may contain areas with a striking resemblance to conventional clear cell renal cell carcinomas. Given this tumour heterogeneity, the potential for sampling error associated with a small core biopsy specimen means that caution should be exhibited when attempting to make a diagnosis of CCP-RCC on core biopsy. Radiologically, these tumors are indistinct from other renal cell carcinomas, appearing as a solid enhancing heterogenous mass following the administration of IV contrast.

Bottom Line: Thought to only arise in those with end stage renal disease, CCP-RCC is increasingly identified in those without renal impairment.Immunohistochemically, these tumors are positive for CK7 and negative for CD10 and racemase.These tumours appear to be indolent in nature, with no current documented cases of metastatic spread.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, The Canberra Hospital, Garran, ACT 2605, Australia.

ABSTRACT
Clear cell papillary renal cell carcinoma (CCP-RCC) is a recently described, relatively uncommon variant of renal cell carcinoma (RCC) with a reported incidence of 4.1%. Thought to only arise in those with end stage renal disease, CCP-RCC is increasingly identified in those without renal impairment. CCP-RCCs have unique morphologic, genetic, and immunohistochemical features distinguishing them from both conventional clear cell renal cell carcinomas and papillary renal cell carcinomas. Immunohistochemically, these tumors are positive for CK7 and negative for CD10 and racemase. This is in contrast to conventional cell renal cell carcinomas (CK7 negative, CD10 positive) and papillary cell carcinomas (CK7, CD10, and racemase positive). These tumours appear to be indolent in nature, with no current documented cases of metastatic spread. We present the case of a 42-year-old female who presented with an incidental finding of a renal mass that on a core biopsy was reported as clear cell carcinoma, Fuhrman grade 1. She subsequently underwent a radical nephrectomy and further histological examination revealed the tumor to be a clear cell papillary renal cell carcinoma, Fuhrman grade 1.

No MeSH data available.


Related in: MedlinePlus