Difference between revisions of "Clear cell papillary renal cell tumour"

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*Good prognosis - based on a small series.<ref name=pmid20924276/>
*Good prognosis - based on a small series.<ref name=pmid20924276/>
*Fourth most common type of RCC is a recent series.<ref name=pmid24182559>{{Cite journal  | last1 = Zhou | first1 = H. | last2 = Zheng | first2 = S. | last3 = Truong | first3 = LD. | last4 = Ro | first4 = JY. | last5 = Ayala | first5 = AG. | last6 = Shen | first6 = SS. | title = Clear cell papillary renal cell carcinoma is the fourth most common histologic type of renal cell carcinoma in 290 consecutive nephrectomies for renal cell carcinoma. | journal = Hum Pathol | volume =  | issue =  | pages =  | month = Oct | year = 2013 | doi = 10.1016/j.humpath.2013.08.004 | PMID = 24182559 }}</ref>
*Fourth most common type of RCC is a recent series.<ref name=pmid24182559>{{Cite journal  | last1 = Zhou | first1 = H. | last2 = Zheng | first2 = S. | last3 = Truong | first3 = LD. | last4 = Ro | first4 = JY. | last5 = Ayala | first5 = AG. | last6 = Shen | first6 = SS. | title = Clear cell papillary renal cell carcinoma is the fourth most common histologic type of renal cell carcinoma in 290 consecutive nephrectomies for renal cell carcinoma. | journal = Hum Pathol | volume =  | issue =  | pages =  | month = Oct | year = 2013 | doi = 10.1016/j.humpath.2013.08.004 | PMID = 24182559 }}</ref>
**Most common (in order): [[clear cell RCC]], [[papillary RCC]], [[chromophobe RCC]].
**Most common (in order): [[clear cell RCC]], [[papillary RCC]], [[chromophobe RCC]], [[clear cell papillary RCC]].


==Microscopic==
==Microscopic==

Revision as of 02:31, 15 November 2013

Clear cell papillary renal cell tumour
Diagnosis in short

Clear cell papillary renal cell carcinoma. H&E stain.
LM apical nuclei, clear cells, pseudopapillae, cystic and/or tubular architectures
LM DDx papillary renal cell carcinoma, clear cell renal cell carcinoma, Xp11.2 translocation carcinoma
IHC CK7 +ve, AMACR -ve, CD10 -ve, TFE3 -ve
Site kidney - see renal tumours
Prevalence uncommon
Prognosis good
Clin. DDx other renal tumours

Clear cell papillary renal cell carcinoma, abbreviated CCPRCC, is recently described type of renal cell carcinoma.

It is also known as clear cell tubulopapillary renal cell carcinoma.[1]

General

Microscopic

Features:[1]

  • Features of both:
    1. Clear cell RCC.
      • Clear cells.
    2. Papillary RCC.
      • Pseudopapillae - often do not have true papillae.
  • Apical nuclei - key feature.[5]
    • In most glandular structures the nuclei are usu. basally located, i.e. in the cytoplasm adjacent to the basement membrane.
  • Tubular and/or cystic architecture.

DDx:

Images

  • CCPRCC - high mag. (WC/Nephron)

  • CCPRCC - very high mag. (WC/Nephron)

www:

IHC

Features:[1]

  • CK7 +ve.
    • Usually -ve in clear cell RCC.
  • CD10 -ve.
    • Usually +ve in clear cell RCC.
    • Positive in Xp11.2 translocation carcinoma.[6]
  • TFE3 -ve.
  • AMACR -ve.
  • Smooth muscle actin +ve (focal).[7]

Others:[1]

  • HIF-1alpha +ve.
  • GLUT-1 +ve.

How to remember: The two key stains are opposite of what the name implies.

  • Clear cell RCC: CK7 negative. In this tumour it is the opposite - CK7 is positive.
  • Papillary RCC: AMACR positive. In this tumour it is the opposite - AMACR is negative.

See also

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Rohan, SM.; Xiao, Y.; Liang, Y.; Dudas, ME.; Al-Ahmadie, HA.; Fine, SW.; Gopalan, A.; Reuter, VE. et al. (Sep 2011). "Clear-cell papillary renal cell carcinoma: molecular and immunohistochemical analysis with emphasis on the von Hippel-Lindau gene and hypoxia-inducible factor pathway-related proteins.". Mod Pathol 24 (9): 1207-20. doi:10.1038/modpathol.2011.80. PMID 21602815.
  2. ↑ Rohan, SM.; Xiao, Y.; Liang, Y.; Dudas, ME.; Al-Ahmadie, HA.; Fine, SW.; Gopalan, A.; Reuter, VE. et al. (Sep 2011). "Clear-cell papillary renal cell carcinoma: molecular and immunohistochemical analysis with emphasis on the von Hippel-Lindau gene and hypoxia-inducible factor pathway-related proteins.". Mod Pathol 24 (9): 1207-20. doi:10.1038/modpathol.2011.80. PMID 21602815.
  3. ↑ 3.0 3.1 Aydin, H.; Chen, L.; Cheng, L.; Vaziri, S.; He, H.; Ganapathi, R.; Delahunt, B.; Magi-Galluzzi, C. et al. (Nov 2010). "Clear cell tubulopapillary renal cell carcinoma: a study of 36 distinctive low-grade epithelial tumors of the kidney.". Am J Surg Pathol 34 (11): 1608-21. doi:10.1097/PAS.0b013e3181f2ee0b. PMID 20924276.
  4. ↑ Zhou, H.; Zheng, S.; Truong, LD.; Ro, JY.; Ayala, AG.; Shen, SS. (Oct 2013). "Clear cell papillary renal cell carcinoma is the fourth most common histologic type of renal cell carcinoma in 290 consecutive nephrectomies for renal cell carcinoma.". Hum Pathol. doi:10.1016/j.humpath.2013.08.004. PMID 24182559.
  5. ↑ Bing, Z.; Tomaszewski, JE. (2011). "Case Report: Clear Cell Papillary Renal Cell Carcinoma in the Bilateral Native Kidneys after 2 Years of Renal Transplantation: Report of a Case and Review of the Literature.". Case Reports in Transplantation 2011. doi:10.1155/2011/387645. http://www.hindawi.com/crim/transplantation/2011/387645/cta/.
  6. ↑ He, H.; Zhou, GX.; Zhou, M.; Chen, L. (Sep 2011). "The distinction of clear cell carcinoma of the female genital tract, clear cell renal cell carcinoma, and translocation-associated renal cell carcinoma: an immunohistochemical study using tissue microarray.". Int J Gynecol Pathol 30 (5): 425-30. doi:10.1097/PGP.0b013e318214dd4f. PMID 21804394.
  7. ↑ Williamson, SR.; Eble, JN.; Cheng, L.; Grignon, DJ. (May 2013). "Clear cell papillary renal cell carcinoma: differential diagnosis and extended immunohistochemical profile.". Mod Pathol 26 (5): 697-708. doi:10.1038/modpathol.2012.204. PMID 23238627.
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