Difference between revisions of "Benign clear cell clusters of the kidney"

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'''Benign clear cell clusters of the kidney''' are a rare finding that may be confused for [[renal cell carcinoma]]<ref name=pmid33447899>{{cite journal |vauthors=Ortiz-Rey JA, Fachal C, Juaneda-Magdalena L, Muñoz-Martín M, Repáraz-Andrade A, Teijeira S, Lamas-Barreiro JM, Almuster-Domínguez S, San Miguel-Fraile P, Gómez-de María C |title=Clear cell clusters in the kidney: a rare finding that should not be misdiagnosed as renal cell carcinoma |journal=Virchows Arch |volume= |issue= |pages= |date=January 2021 |pmid=33447899 |doi=10.1007/s00428-021-03018-4 |url=}}</ref> or may represent a precursor lesion of renal cell carcinoma.<ref>Ross J, He H, Lin X, Yang X, "Clear cell cluster in the kidney: Is this a precursor lesion of renal cell carcinoma?", USCAP Annual Meeting 2018, Abstrct ID# 1058.</ref>
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Benign clear cell clusters in the kidney -- intermed mag.jpg
| Width      =
| Caption    = Benign clear cell clusters of the kidney. [[H&E stain]].
| Synonyms  =
| Micro      = large cells in "small" nests with voluminous clear cytoplasm and small nuclei without prominent nucleoli
| Subtypes  =
| LMDDx      = [[chromophobe renal cell carcinoma]], other [[clear cell tumours]]
| Stains    =
| IHC        = PAX8 +ve, CK7 +ve, AMACR -ve, CD68 -ve, CD10 +ve/-ve, CD117 +ve/-ve, vimentin -ve, CA9 -ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Staging    =
| Site      = [[kidney]] - see ''[[kidney tumours]]''
| Assdx      =
| Syndromes  =
| Clinicalhx = chronic renal insufficiency
| Signs      =
| Symptoms  =
| Prevalence = very rare
| Bloodwork  =
| Rads      = +/-renal mass
| Endoscopy  =
| Prognosis  = presumed benign based on limited data/unknown
| Other      =
| ClinDDx    =
| Tx        =
}}
'''Benign clear cell clusters of the kidney''' are a rare finding that may be confused for [[renal cell carcinoma]]<ref name=pmid33447899>{{cite journal |authors=Ortiz-Rey JA, Fachal C, Juaneda-Magdalena L, Muñoz-Martín M, Repáraz-Andrade A, Teijeira S, Lamas-Barreiro JM, Almuster-Domínguez S, San Miguel-Fraile P, Gómez-de María C |title=Clear cell clusters in the kidney: a rare finding that should not be misdiagnosed as renal cell carcinoma |journal=Virchows Arch |volume= |issue= |pages= |date=January 2021 |pmid=33447899 |doi=10.1007/s00428-021-03018-4 |url=}}</ref> or may represent a precursor lesion of renal cell carcinoma.<ref>Ross J, He H, Lin X, Yang X, "Clear cell cluster in the kidney: Is this a precursor lesion of renal cell carcinoma?", USCAP Annual Meeting 2018, Abstrct ID# 1058.</ref>


==General==
==General==
*Associated with chronic renal disease.
*Associated with [[chronic renal failure|chronic renal insufficiency]].


==Microscopic==
==Microscopic==
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*Large cells predominantly in "small" nests with:
*Large cells predominantly in "small" nests with:
**Voluminous clear cytoplasm.
**Voluminous clear cytoplasm.
**Small nuclei without prominent nucleoli.
**Small nuclei without prominent nucleoli ([[ISUP nucleolar grade]] 1 or 2).


Notes:
Notes:
*Tubules with narrow lumens may be present.
*Tubules with narrow lumens may be present.
*"Small": typically less than 1.5 mm.
*"Small" nests: typically less than 1.5 mm.


DDx:
DDx:
*[[Chromophobe renal cell carcinoma]].
*[[Clear cell renal cell carcinoma]].
*[[Clear cell renal cell carcinoma]].
*[[Chromophobe renal cell carcinoma]].
*Other [[clear cell tumours]].
*Other [[clear cell tumours]].
===Images===
<gallery>
Image: Benign clear cell clusters in the kidney -- very low mag.jpg | BCCC - very low mag. (WC)
Image: Benign clear cell clusters in the kidney -- low mag.jpg | BCCC - low mag. (WC)
Image: Benign clear cell clusters in the kidney -- intermed mag.jpg | BCCC - intermed. mag. (WC)
Image: Benign clear cell clusters in the kidney - alt -- intermed mag.jpg | BCCC - intermed. mag. (WC)
Image: Benign clear cell clusters in the kidney -- high mag.jpg | BCCC - high mag. (WC)
Image: Benign clear cell clusters in the kidney - alt -- high mag.jpg | BCCC - high mag. (WC)
Image: Benign clear cell clusters in the kidney -- very high mag.jpg | BCCC - very high mag. (WC)
</gallery>


==IHC==
==IHC==
Features:<ref name=pmid33447899/>
Features:<ref name=pmid33447899/>
*PAX8 +ve.
*[[PAX8]] +ve.
*AE1/AE3 +ve.
*AE1/AE3 +ve.
*CK7 +ve.
*[[CK7]] +ve.
*EMA +ve.
*EMA +ve.
*CD10 typically focal.
*CD10 typically focal.
*CA IX -ve.
 
Others:<ref name=pmid33447899/>
*[[CA9]] -ve.
*vimentin -ve.
*vimentin -ve.
*AMACR -ve.
*AMACR -ve.
Line 34: Line 79:
*Melan A -ve.
*Melan A -ve.
*HMB-45 -ve.
*HMB-45 -ve.
===Images===
<gallery>
Image: Benign clear cell clusters in the kidney -- very low mag.jpg | BCCC - very low mag. (WC)
Image: Benign clear cell clusters in the kidney -- low mag.jpg | BCCC - low mag. (WC)
Image: Benign clear cell clusters in the kidney -- intermed mag.jpg | BCCC - intermed. mag. (WC)
Image: Benign clear cell clusters in the kidney - alt -- intermed mag.jpg | BCCC - intermed. mag. (WC)
Image: Benign clear cell clusters in the kidney -- high mag.jpg | BCCC - high mag. (WC)
Image: Benign clear cell clusters in the kidney - alt -- high mag.jpg | BCCC - high mag. (WC)
Image: Benign clear cell clusters in the kidney -- very high mag.jpg | BCCC - very high mag. (WC)
</gallery>


==See also==
==See also==

Latest revision as of 17:21, 25 March 2021

Benign clear cell clusters of the kidney
Diagnosis in short

Benign clear cell clusters of the kidney. H&E stain.
LM large cells in "small" nests with voluminous clear cytoplasm and small nuclei without prominent nucleoli
LM DDx chromophobe renal cell carcinoma, other clear cell tumours
IHC PAX8 +ve, CK7 +ve, AMACR -ve, CD68 -ve, CD10 +ve/-ve, CD117 +ve/-ve, vimentin -ve, CA9 -ve
Site kidney - see kidney tumours
Clinical history chronic renal insufficiency
Prevalence very rare
Radiology +/-renal mass
Prognosis presumed benign based on limited data/unknown

Benign clear cell clusters of the kidney are a rare finding that may be confused for renal cell carcinoma[1] or may represent a precursor lesion of renal cell carcinoma.[2]

General

Microscopic

Features:

  • Large cells predominantly in "small" nests with:

Notes:

  • Tubules with narrow lumens may be present.
  • "Small" nests: typically less than 1.5 mm.

DDx:

Images

  • BCCC - very low mag. (WC)

  • BCCC - low mag. (WC)

  • BCCC - intermed. mag. (WC)

  • BCCC - intermed. mag. (WC)

  • BCCC - high mag. (WC)

  • BCCC - high mag. (WC)

  • BCCC - very high mag. (WC)

IHC

Features:[1]

  • PAX8 +ve.
  • AE1/AE3 +ve.
  • CK7 +ve.
  • EMA +ve.
  • CD10 typically focal.

Others:[1]

  • CA9 -ve.
  • vimentin -ve.
  • AMACR -ve.
  • CD68 -ve.
  • Alpha-inhibin -ve.
  • Calretinin -ve.
  • Melan A -ve.
  • HMB-45 -ve.

See also

References

  1. ↑ 1.0 1.1 1.2 Ortiz-Rey JA, Fachal C, Juaneda-Magdalena L, Muñoz-Martín M, Repáraz-Andrade A, Teijeira S, Lamas-Barreiro JM, Almuster-Domínguez S, San Miguel-Fraile P, Gómez-de María C (January 2021). "Clear cell clusters in the kidney: a rare finding that should not be misdiagnosed as renal cell carcinoma". Virchows Arch. doi:10.1007/s00428-021-03018-4. PMID 33447899.
  2. ↑ Ross J, He H, Lin X, Yang X, "Clear cell cluster in the kidney: Is this a precursor lesion of renal cell carcinoma?", USCAP Annual Meeting 2018, Abstrct ID# 1058.
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