Clear cell papillary renal cell tumour

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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

  • New entity not in the WHO classification.

Microscopic

Features:[1]

  • Features of both:
    1. Clear cell RCC.
    2. Papillary RCC.
      • Often do not have true papillae.
  • Apical nuclei - key feature.[2]
    • In most glandular structures the nuclei are usu. basally located, i.e. in the cytoplasm adjacent to the basement membrane.

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.[3]
  • TFE3 -ve.
  • AMACR -ve.
  • Smooth muscle actin +ve (focal).[4]

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 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. ↑ 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/.
  3. ↑ 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.
  4. ↑ 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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