Renal cell carcinomas with papillary architecture and clear cell components

The utility of immunohistochemical and cytogenetical analyses in differential diagnosis

Stefano Gobbo, John Eble, Gregory T. MacLennan, David Grignon, Rajal B. Shah, Shaobo Zhang, Guido Martignoni, Matteo Brunelli, Liang Cheng

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

Although histologic features enable an accurate diagnosis in most renal carcinomas, overlapping morphologic findings between some renal neoplasms make subclassification difficult. Some renal carcinomas show papillary architecture but are composed extensively of cells with clear cytoplasm, and it is unclear whether they should be classified as clear cell renal cell carcinomas or papillary renal cell carcinomas. We analyzed the immunohistochemical profiles and the cytogenetic patterns of 14 renal carcinomas showing papillary architecture in which there were variable amounts of cells with clear cytoplasm. The patients were 8 women and 6 men (mean age: 54 y). mmunohistochemistry and fluorescence in situ hybridization analysis distinguished 2 different groups. The first consisted of 10 renal cell carcinomas with strong immunoreactivity for α-methyl coenzyme A racemase, of which 9 also expressed cytokeratin 7. All of these neoplasms showed gains of chromosome 7 or 17 and chromosome Y was lost in all the male patients whereas 3p deletion was detected only in one case. In the other 4 renal cell carcinomas, cytokeratin 7 was not detected and α-methylacyl-CoA racemase was positive in only 1. In these neoplasms, no gain of chromosome 7 or 17 and no loss of chromosome Y were observed, whereas 3p deletion was detected in 3 of them. None of the 14 neoplasms showed immunoreactivity for TFE3. The combined use of immunohistochemistry and cytogenetics enabled us to provide a definitive diagnosis for 12 of 14 renal cell carcinomas with papillary architecture and clear cell components: 9 cases were confirmed to be papillary renal cell carcinomas and 3 cases were confirmed to be clear cell renal cell carcinomas. Despite these ancillary techniques, 2 cases remained unclassified. Our study establishes the utility of these procedures in accurately classifying the great majority of renal cell carcinomas with these findings.

Original languageEnglish
Pages (from-to)1780-1786
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume32
Issue number12
DOIs
StatePublished - Dec 2008

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Cellular Structures
Renal Cell Carcinoma
Differential Diagnosis
Keratin-7
Racemases and Epimerases
Chromosomes, Human, Pair 17
Chromosomes, Human, Pair 7
Papillary Carcinoma
Y Chromosome
Coenzyme A
Kidney
Cytogenetics
Cytoplasm
Neoplasms
Kidney Neoplasms
Fluorescence In Situ Hybridization
Immunohistochemistry
Carcinoma

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery
  • Medicine(all)

Cite this

Renal cell carcinomas with papillary architecture and clear cell components : The utility of immunohistochemical and cytogenetical analyses in differential diagnosis. / Gobbo, Stefano; Eble, John; MacLennan, Gregory T.; Grignon, David; Shah, Rajal B.; Zhang, Shaobo; Martignoni, Guido; Brunelli, Matteo; Cheng, Liang.

In: American Journal of Surgical Pathology, Vol. 32, No. 12, 12.2008, p. 1780-1786.

Research output: Contribution to journalArticle

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