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Nikolic G, Zivotic M, Cirovic S, Despotovic S, Dundjerovic D, Radojevic Skodric S. The Utility of Mitochondrial Detection Methods Applied as an Additional Tool for the Differentiation of Renal Cell Tumors. Diagnostics (Basel) 2023; 13:2319. [PMID: 37510063 PMCID: PMC10377759 DOI: 10.3390/diagnostics13142319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/13/2023] [Accepted: 06/17/2023] [Indexed: 07/30/2023] Open
Abstract
The precise differentiation of renal cell tumors (RCTs) is sometimes hard to achieve using standard imaging and histopathological methods, especially for those with eosinophilic features. It has been suggested that the vast overabundance of mitochondria, as a well-known hallmark of eosinophilic cytoplasm, and could be a characteristic of distinct tumor types with opposing clinical outcomes. Thus, we intended to explore the associations between mitochondrial distribution patterns in different RCTs, including 43 cell renal cell carcinomas (ccRCCs), 15 papillary renal cell carcinomas (pRCCs), 20 chromophobe renal cell carcinomas (chRCCs), and 18 renal oncocytomas (ROs). Tumor samples were stained with two anti-mitochondrial antibodies (mitochondrial antibody Ab-2, clone MTC02; prohibitin, II-14-10, MA5-12858), applying immunohistochemistry and immunofluorescence to define mitochondrial distribution patterns (coarse scanty, moderate granular, and diffuse granular). Our results revealed significantly different expression patterns among the investigated RCTs (p < 0.001). The majority of ccRCCs exhibited coarse scanty mitochondrial staining, while all chRCCs had moderate granular expression. Nevertheless, all ROs, all pRCCs, and two cases of ccRCC presenting with higher nuclear grade and eosinophilic cytoplasm had diffuse granular mitochondrial expression. Moreover, with increased distribution of mitochondria, the intensity of staining was higher (p < 0.001). Here we present a strategy that utilizes fast and easy mitochondrial detection to differentiate RO from chRCC, as well as other eosinophilic variants of RCC with high accuracy.
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Affiliation(s)
- Gorana Nikolic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Maja Zivotic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Sanja Cirovic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Sanja Despotovic
- Institute for Histology and Embryology "Aleksandar Đ. Kostić", Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Dusko Dundjerovic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
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Gonzalez ML, Alaghehbandan R, Pivovarcikova K, Michalova K, Rogala J, Martinek P, Foix MP, Mundo EC, Comperat E, Ulamec M, Hora M, Michal M, Hes O. Reactivity of CK7 across the spectrum of renal cell carcinomas with clear cells. Histopathology 2019; 74:608-617. [PMID: 30444288 DOI: 10.1111/his.13791] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 01/25/2023]
Abstract
AIMS Current available data on cytokeratin 7 (CK7) immunostaining pattern in the clear cell renal cell carcinoma (RCC) spectrum is conflicting. The aim of this study was to assess CK7 immunoreactivity within the spectrum of clear cell renal neoplasms, including clear cell RCC, multicystic renal neoplasm of low malignant potential and clear cell papillary RCC-like tumours. METHODS AND RESULTS We analysed two clones of CK7 and two tumour blocks for a total of 75 cases divided into five distinct groups: (i) low-grade clear cell RCC, (ii) high-grade clear cell RCC, (iii) multicystic renal neoplasm of low malignant potential, (iv) clear cell RCC with cystic changes and (v) clear cell papillary RCC-like tumours. We found the highest CK7 reactivity in low-grade clear cell RCC, multicystic renal neoplasm of low malignant potential and clear cell papillary RCC-like groups, ranging from 60% to 93%. CONCLUSIONS Our findings show that CK7 immunoreactivity in clear cell RCC is variable, and the extent of staining depends on the grade and architectural growth patterns of the tumours.
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Affiliation(s)
- Manuel L Gonzalez
- Department of Pathology, University of Kansas, Medical Center, Kansas City, Kansas, USA
| | - Reza Alaghehbandan
- Department of Pathology, Faculty of Medicine, University of British Columbia, Royal Columbian Hospital, Vancouver, BC, Canada
| | - Krystina Pivovarcikova
- Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzeň, Pilsen, Czech Republic
| | - Kvetoslava Michalova
- Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzeň, Pilsen, Czech Republic
| | - Joanna Rogala
- Department of Pathology, University Hospital Wroclaw, Wroclaw, Poland
| | - Petr Martinek
- Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzeň, Pilsen, Czech Republic
| | - María P Foix
- Department of Pathology, Bellvitge Biomedical Research Institut (IDIBELL), Bellvitge University Hospital, University of Barcelona School of Medicine, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Enric C Mundo
- Department of Pathology, Bellvitge Biomedical Research Institut (IDIBELL), Bellvitge University Hospital, University of Barcelona School of Medicine, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Eva Comperat
- Department of Pathology, Hospital Tenon, Paris, Sorbonne University, Paris, France
| | - Monika Ulamec
- 'Ljudevit Jurak' Pathology Department, Clinical Hospital Center 'Sestre milosrdnice', Pathology Department, Medical University, Medical Faculty Zagreb, Zagreb, Croatia
| | - Milan Hora
- Department of Urology, Charles University in Prague, Faculty of Medicine in Plzeň, Pilsen, Czech Republic
| | - Michal Michal
- Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzeň, Pilsen, Czech Republic
| | - Ondrej Hes
- Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzeň, Pilsen, Czech Republic
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Chauhan A, Semwal DK, Mishra SP, Goyal S, Marathe R, Semwal RB. Combination of mTOR and MAPK Inhibitors-A Potential Way to Treat Renal Cell Carcinoma. Med Sci (Basel) 2016; 4:medsci4040016. [PMID: 29083380 PMCID: PMC5635794 DOI: 10.3390/medsci4040016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 09/17/2016] [Accepted: 10/10/2016] [Indexed: 12/19/2022] Open
Abstract
Renal cell carcinoma (RCC) is the most common neoplasm that occurs in the kidney and is marked by a unique biology, with a long history of poor response to conventional cancer treatments. In the past few years, there have been significant advancements to understand the biology of RCC. This has led to the introduction of novel targeted therapies in the management of patients with metastatic disease. Patients treated with targeted therapies for RCC had shown positive impact on overall survival, however, no cure is possible and patients need to undergo treatment for long periods of time, which raises challenges to manage the associated adverse events. Moreover, many patients may not respond to it and even response may not last long enough in the responders. Many inhibitors of the Mammalian target of Rapamycin (mTOR) signaling pathway are currently being used in treatment of advanced RCC. Studies showed that inhibitions of mTOR pathways induce Mitogen-Activated Protein Kinase (MAPK) escape cell death and cells become resistant to mTOR inhibitors. Because of this, there is a need to inhibit both pathways with their inhibitors comparatively for a better outcome and treatment of patients with RCC.
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Affiliation(s)
- Ashutosh Chauhan
- Department of Urology, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India.
- Department of Biotechnology, Faculty of Biomedical Sciences, Uttarakhand Ayurved University, Harrawala, Dehradun 248001, Uttarakhand, India.
| | - Deepak Kumar Semwal
- Department of Phytochemistry, Faculty of Biomedical Sciences, Uttarakhand Ayurved University, Harrawala, Dehradun 248001, Uttarakhand, India.
| | - Satyendra Prasad Mishra
- Vice Chancellor, Uttarakhand Ayurved University, Harrawala, Dehradun 248001, Uttarakhand, India.
| | - Sandeep Goyal
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India.
| | - Rajendra Marathe
- Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India.
| | - Ruchi Badoni Semwal
- Department of Pharmaceutical Sciences, Tshwane University of Technology, Pretoria 0001, South Africa.
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Diagnostic utility of vimentin, CD117, cytokeratin-7 and caveolin-1 in differentiation between clear cell renal cell carcinoma, chromophobe renal cell carcinoma and oncocytoma. J Microsc Ultrastruct 2016; 5:90-96. [PMID: 30023241 PMCID: PMC6025761 DOI: 10.1016/j.jmau.2016.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 06/18/2016] [Accepted: 07/19/2016] [Indexed: 11/23/2022] Open
Abstract
Overlapping morphological characteristics pose some difficulties in making a proper diagnosis of clear cell renal cell carcinoma (CCRCC), chromophobe renal cell carcinoma (ChRCC), and oncocytoma, on the basis of hematoxylin-eosin-stained tissue sections. Our objective was to find out a fast, reliable panel of immunohistochemical markers for differentiation between them. The study was carried out on 55 selected renal tumor specimens: 36 cases of CCRCC, seven cases of ChRCC, and 12 cases of oncocytoma. The specimens were stained immunohistochemically for vimentin, CD117, cytokeratin (CK)7, and caveolin (Cav)-1. Sensitivity and specificity for each marker were calculated. Vimentin expression was exclusively observed in CCRCC (100%) and negative in ChRCC and oncocytoma. CD117 was absent in CCRCC, but it was strongly expressed in ChRCC (85.5%) and oncocytoma (91.7%), with high sensitivity and specificity. Most CCRCCs and oncocytomas were negative for CK7 (91.7% and 83.3%, respectively), in contrast to ChRCCs, which showed positivity in nearly 86% of the cases. Good sensitivity and specificity were calculated for CK7 in differentiating studied oncocytic tumors. Cav-1 was positive in ~78% of the CCRCCs and in all ChRCCs, whereas the vast majority of oncocytomas were negative. So the immunoprofile of CCRCC was vimentin+/CD117-/CK7-/Cav-1±, ChRCC was vimentin-/CD117+/CK7+/Cav-1+, and oncocytoma was vimentin-/CD117+/CK7±/Cav-1-. So, by using combination of four markers (vimentin, CD117, CK7, and Cav-1), we achieved excellent sensitivity and specificity for differential diagnosis of CCRCC, ChRCC and oncocytoma.
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Clinicopathological Significance of Vimentin and Cytokeratin Protein in the Genesis of Squamous Cell Carcinoma of Cervix. Obstet Gynecol Int 2016; 2016:8790120. [PMID: 27190522 PMCID: PMC4848446 DOI: 10.1155/2016/8790120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 01/19/2016] [Accepted: 02/14/2016] [Indexed: 11/20/2022] Open
Abstract
Cervical cancer is one of the commonest types of cancers worldwide especially in developing countries. Intermediate filaments protein family has shown a role in the diagnosis of various cancers, but a few studies are available about the vimentin and cytokeratin roles in the cervical cancer. This case control study aimed to interpret the expression of vimentin and cytokeratin proteins in the development and progression of cervical cancer and its correlation with clinicopathological features. The cytoplasmic expression of vimentin was observed in 40% of cases, but not in inflammatory lesions of cervix. It was noticed that vimentin expression was increasing significantly with high grade of the tumour. Cytokeratin expression was observed in 48.33% and it was noticed that the expression was 62.5% in well differentiated (G1), 45% in moderately differentiated (G2), and 41.66% in poorly differentiated carcinoma, yet statistically insignificant. The expression of vimentin and cytokeratin proteins was not significantly associated with age groups. The current findings concluded a possible role of vimentin in the development and progression of cervical cancer and vimentin marker will be useful in the diagnosis and grading of cervical cancer.
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Din NU, Fatima S, Ahmad Z. Chromophobe renal cell carcinoma: a morphologic and immunohistochemical study of 45 cases. Ann Diagn Pathol 2013; 17:508-13. [PMID: 24095630 DOI: 10.1016/j.anndiagpath.2013.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 06/14/2013] [Accepted: 06/24/2013] [Indexed: 01/27/2023]
Abstract
The aim of this study was to evaluate the morphological spectrum of chromophobe renal cell carcinoma (CRCC) and diagnostic utility of a panel of three immunohistochemical stains. All cases of CRCC reported between 2002 and 2012 in the Section of Histopathology, Aga Khan University Hospital, were retrieved. A total of 45 cases were identified. Slides were reviewed and immunohistochemical stains (CK7, CD117, and vimentin) were performed. Ages ranged from 18 to 90 years (mean, 48.5 years). Male-to-female ratio was 0.8:1. The tumor was located in the left kidney in 24 patients and the right kidney in 20 patients. The tumor size ranged from 3.5 to 22 cm (mean 10 cm). Histologically, 4 were classic, 22 were eosinophilic, 16 were mixed, and 3 were sarcomatoid type. Morphologic patterns included broad alveolar, solid, nested, tubular, tubulocystic, trabecular, papillary, and microglandular. Binucleation and perinuclear halos were seen in all cases. Nuclear grooves and pseudoinclusions were seen in 17 and 6 cases, respectively. Multinucleated cells were seen in 19 cases. Mitoses ranged from 1 to 11/10 HPFs (mean 3/10 HPFs). Hyalinized stroma was seen in 38 cases and calcification in 26 cases. Necrosis was seen in 18 cases. Palisading of smaller cells around the broad alveolar pattern was noted in 5 cases. The Furhman's nuclear grade was I (11), II (26), III (5), and IV (3). Hale's colloidal iron was positive in all cases. Immunohistochemical stain CK7 and CD117 were positive in 100% and 95.5% of cases respectively. Vimentin was negative in all cases, except in the sarcomatoid areas of 3 cases. In conclusion, chromophobe renal cell carcinoma has certain unique morphological features and immunohistochemical profile which help to distinguish it from conventional renal cell carcinoma and oncocytoma. We identified nuclear pseudoinclusions, microglandular pattern and palisading of smaller cells, which have not been reported earlier.
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Affiliation(s)
- Nasir Ud Din
- Histopathology, Department of Pathology and Microbiology, Aga Khan University Hospital, Karachi, Pakistan.
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Kren L, Valkovsky I, Dolezel J, Capak I, Pacik D, Poprach A, Lakomy R, Redova M, Fabian P, Krenova Z, Slaby O. HLA-G and HLA-E specific mRNAs connote opposite prognostic significance in renal cell carcinoma. Diagn Pathol 2012; 7:58. [PMID: 22640987 PMCID: PMC3408319 DOI: 10.1186/1746-1596-7-58] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Accepted: 05/29/2012] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Renal cell carcinoma (RCC) is characterized by its resistance to radiotherapy and/or chemotherapy. On the other hand, it is an immunogenic tumor - it is able to stimulate antitumor responses. A prognostic significance of HLA-G expression by neoplastic cells in RCC is not well characterized; significance HLA-E expression in RCC is not characterized at all. METHODS In our study, we evaluated the expression of HLA-G and HLA-E specific mRNA transcripts produced by neoplastic cells in 38 cases of RCC and in 10 samples of normal kidney parenchyma. The results were statistically correlated with various clinico-pathological parameters. RESULTS We confirmed that HLA-G is downregulated in normal kidney tissue; if it is up-regulated in RCC, then it is connected to worse prognosis. On the other hand, HLA-E mRNA transcripts were present in both normal kidney tissue and RCC and their increasing concentrations counterintuitively carried better prognosis, more favorable pT stage and lower nuclear Fuhrmann's grade. CONCLUSION Considering the fact that there is known aberrant activation of HLA-G and HLA-E expression by interferons, identification of HLA-G and HLA-E status could contribute to better selection of RCC patients who could possibly benefit from more tailored neoadjuvant biological/immunological therapy. Thus, these molecules could represent useful prognostic biomarkers in RCC, and the expression of both these molecules in RCC deserves further study. THE VIRTUAL: Slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/7383071387016614.
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Affiliation(s)
- Leos Kren
- Department of Pathology, Faculty of Medicine, University Hospital Brno, Masaryk University, Jihlavska 20, Brno, 625 00, Czech Republic
| | - Ivo Valkovsky
- Faculty Hospital Ostrava, Clinic of Internal Medicine, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Jan Dolezel
- Department of Oncological Urology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Ivo Capak
- Department of Oncological Urology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Dalibor Pacik
- Department of Urology, Faculty of Medicine, University Hospital Brno, Masaryk University, Brno, Czech Republic
| | - Alexandr Poprach
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Radek Lakomy
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Martina Redova
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Pavel Fabian
- Department of Oncological and Experimental Pathology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Zdenka Krenova
- Department of Childrens’ Oncology, Faculty of Medicine, University Hospital Brno, Masaryk University, Brno, Czech Republic
| | - Ondrej Slaby
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic
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Renal oncocytoma in pregnancy – an unusual presentation of secondary hypertension. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2012. [DOI: 10.1016/j.repce.2012.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Torres R, Borges A, Campos A. [Renal oncocytoma in pregnancy--an unusual presentation of secondary hypertension]. Rev Port Cardiol 2012; 31:385-8. [PMID: 22480938 DOI: 10.1016/j.repc.2011.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 10/11/2011] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION Renal oncocytoma accounts for 5-7% of primary renal neoplasms. It is usually, diagnosed in asymptomatic patients and is characterized by a benign behavior without invasion of adjacent tissues or metastasis. Diagnosis during pregnancy is uncommon and to date there have been only a few cases reported in the literature. CASE REPORT The authors present the case of a 32-year-old nulliparous woman with uncontrolled hypertension diagnosed at seven weeks gestation. She was referred to our institution at 24 weeks with superimposed pre-eclampsia complicated by acute pulmonary edema and hemodynamic instability requiring mechanical ventilatory support, fetal growth restriction and stillbirth. Etiological study of the hypertensive disorder performed in the postpartum period was consistent with renal oncocytoma. CONCLUSION The clinical behavior of renal oncocytoma remains poorly characterized during pregnancy and may lead to an adverse maternal and fetal outcome despite its theoretically benign behavior. It is essential to exclude a possible secondary cause of hypertension in cases that are difficult to control.
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Affiliation(s)
- Rita Torres
- Internato Médico em Ginecologia-Obstetrícia, Maternidade Dr. Alfredo da Costa, Lisboa, Portugal.
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Singh C, Xie L, Schmechel SC, Manivel JC, Pambuccian SE. Epithelioid angiosarcoma of the kidney: a diagnostic dilemma in fine-needle aspiration cytology. Diagn Cytopathol 2011; 40 Suppl 2:E131-9. [PMID: 21698784 DOI: 10.1002/dc.21762] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Accepted: 05/21/2011] [Indexed: 02/07/2023]
Abstract
Epithelioid angiosarcomas (EAS) of kidney are rare and aggressive tumors with noncharacteristic imaging features that overlap with those of inflammatory conditions and renal cell carcinoma (RCC). We report the fine-needle aspiration (FNA) cytology findings of a case of EAS that involved the left kidney of an 83-year-old male. The smears and cell block sections showed pleomorphic epithelioid cells with ample cytoplasm, eccentric nuclei, occasional cytoplasmic hyaline globules, and rare intracytoplasmic lumina. Immunohistochemical stains performed on cellblock sections showed that the tumor cells were positive for vimentin, CD31, CD34, Factor VIII, and CD10, but showed no staining for cytokeratins AE1/AE3 and 8/18, HMB45, CD45, smooth muscle actin, and S100. The morphological and immunohistochemical distinction between EAS, primary tumors of the kidney, and other epithelioid and rhabdoid neoplasms is discussed.
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Affiliation(s)
- Charanjeet Singh
- Department of Laboratory Medicine & Pathology, University of Minnesota Medical School, 420 Delaware SE, Minneapolis, MN 55455, USA
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Schultz TD, Sergi C, Grundy P, Metcalfe PD. Papillary renal cell carcinoma: report of a rare entity in childhood with review of the clinical management. J Pediatr Surg 2011; 46:e31-4. [PMID: 21683189 DOI: 10.1016/j.jpedsurg.2011.03.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 03/28/2011] [Accepted: 03/30/2011] [Indexed: 10/18/2022]
Abstract
We present the case of a 9-year-old boy who presents with gross hematuria and is subsequently diagnosed with a papillary (type 1) renal cell carcinoma. Management of renal cell carcinoma in the pediatric population represents a unique challenge, owing to the potential for a genetic predisposition and screening. Herein we discuss novel discoveries with respect to pediatric renal cell carcinoma and their potential impact on screening.
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Affiliation(s)
- Troy D Schultz
- Division of Urology, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
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Bárcena C, Martínez MA, Ortega MP, Muñoz HG, Sárraga GU. Mitochondria with tubulovesicular cristae in renal oncocytomas. Ultrastruct Pathol 2011; 34:315-20. [PMID: 21070162 DOI: 10.3109/01913123.2010.506021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Renal oncocytoma and chromophobe renal cell carcinoma (CRCC) are closely related tumors. They are considered the extremes of a spectrum with several variants. Ultrastructural examination of the mitochondria is a helpful procedure in the diagnosis of these neoplasms. Renal oncocytomas show mitochondria with piled lamellar cristae, and CRCC exhibited mitochondria with tubulovesicular cristae. In a series of 23 histologically diagnosed renal oncocytomas examined by electron microscopy, the authors found 5 tumors exhibiting more cells with mitochondria showing tubulovesicular cristae. The authors believe these 5 cases present a submicroscopic appearance intermediate between renal oncocytoma and CRCC, although with benign clinical behavior.
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Affiliation(s)
- C Bárcena
- Service of Pathology, Hospital 12 de Octubre, Madrid, Spain
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Bird VG, Kanagarajah P, Morillo G, Caruso DJ, Ayyathurai R, Leveillee R, Jorda M. Differentiation of oncocytoma and renal cell carcinoma in small renal masses (<4 cm): the role of 4-phase computerized tomography. World J Urol 2010; 29:787-92. [PMID: 20717829 DOI: 10.1007/s00345-010-0586-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Accepted: 07/09/2010] [Indexed: 12/24/2022] Open
Abstract
PURPOSE We investigate the use of 4-phase computerized tomography with intravenous contrast to help distinguish oncocytoma from renal cell carcinoma (RCC) in tumors <4 cm. METHODS We retrospectively identified patients who underwent surgical management for renal tumors <4 cm from 2005 to 2008. Patients who had pre-operative CT evaluation as per our institution's renal mass protocol and had confirmed pathological diagnosis of either oncocytoma or RCC were included in the study. Enhancement readings were obtained for the tumor and the renal cortex using the same slice simultaneously. RESULTS Our cohort involved 69 patients (46 men, 23 women; mean age 66) who presented with 79 renal masses. Histopathologically 40 were clear cell, 22 papillary, 5 chromophobe RCC and 12 oncocytoma. On the arterial, venous and delayed phase images, oncocytoma showed the highest mean enhancement change, i.e.,546, 396 and 239% followed by clear cell RCC 261, 261 and 174%, chromophobe RCC 147, 127 and 66% and papillary RCC 137, 184 and 118%, respectively. The enhancement pattern differed significantly on comparing oncocytoma with RCC (P < 0.007). The mean percentage contrast excreted at the end of the delayed phase was 33.3, 13.8, 32 and 53% for clear cell, papillary, chromophobe and oncocytoma, respectively. CONCLUSION The enhancement and washout values in Hounsfield units obtained by multiphasic CT scan aid in distinguishing oncocytoma from the commonly seen subtypes of RCC in renal masses <4 cm. This preliminary study demonstrates that arterial phase enhancement greater than 500% and washout values of greater than 50% are exclusively seen in renal oncocytomas.
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Affiliation(s)
- Vincent G Bird
- Department of Urology, University of Miami-Miller School of Medicine, PO Box 016960 (M-814), Miami, FL 33101, USA.
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Utility of a dual immunostain cocktail comprising of p53 and CK20 to aid in the diagnosis of non-neoplastic and neoplastic bladder biopsies. Diagn Pathol 2009; 4:35. [PMID: 19828048 PMCID: PMC2766363 DOI: 10.1186/1746-1596-4-35] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2009] [Accepted: 10/14/2009] [Indexed: 12/01/2022] Open
Abstract
Background Distinction between non-neoplastic and neoplastic bladder lesions is therapeutically and prognostically important. Our objective is to describe the use of double immunohistochemistry (DIHC) for p53+CK20 as a tool for diagnosing neoplasia in bladder biopsies. Methods p53+CK20 DIHC were examined in 38 reactive atypia, 10 dysplasia, 9 carcinoma in situ (CIS) and 7 invasive carcinoma (IC) cases. CK20 was evaluated according to distribution extent and degree of intensity whereas percentage of positive cells together with staining intensity was taken into account in the evaluation of p53. Results 92% of reactive cases were either CK20(-) or (+) only in the upper 1/3 urothelium. In dysplastic cases CK20 staining distribution was as follows: 60% in 2/3 of the urothelium, 30% full thickness, 10% in the upper 1/3 urothelium. Among CIS cases, 89% had full thickness CK20 positivity, of which 62% were p53(+). 71% of IC cases exhibited strong and full thickness dual staining. Conclusion This is the first study in the literature to use DIHC of p53+CK20 in distinction of non-neoplastic and neoplastic bladder lesions. Dual staining by p53+CK20 cocktail allows for histologic correlation and diminishes the risk of losing the area of interest in limited biopsy specimens.
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