Cadherin 17 Is a Sensitive and Specific Marker for Metanephric Adenoma

Abstract

Metanephric adenoma (MA) is a rare benign renal neoplasm that shares morphologic and immunophenotypic overlap with epithelial predominant Wilms tumor (e-WT) and with the solid variant of papillary renal cell carcinoma (s-PRCC). Cadherin 17 (CDH17) is expressed primarily in the normal intestine and digestive tract tumors and has not been detected in tumors from other sites including the kidney. We investigated the diagnostic utility of CDH17 in differentiating between MA, e-WT, and s-PRCC. Immunohistochemistry for CDH17, CD57, AMACR, WT-1, and CDX2 was performed on 17 e-WTs, 15 s-PRCCs and 21 MAs and assessed based on a combined score of extent and intensity. Normal adult kidney parenchyma was negative for CDH17 staining. CDH17 was expressed in the late stages of fetal kidney development at the junction of the glomerular space and proximal nephron. The majority of MAs (81%) demonstrated membranous CDH17 immunoreactivity in all components (acinar, tubular, and papillary), while all cases of e-WTs and s-PRCCs were negative (p<0.0001). WT-1 was negative in s-PRCC and was positive in all cases of e-WT and MA. All MAs were strongly positive for CD57; however, this marker was also moderate to strongly positive in 6 (35%) e-WTs and 2 (13%) s-PRCCs. AMACR was strongly positive in all s-PRCCs, but moderate reactivity was seen in 3 (17%) e-WTs and 2 MA (10%). CDH17 is a sensitive (81%) and highly specific (100%) marker for MA, and should be considered in the IHC panel for distinguishing MA from its mimics.

Young investigator challenge: Cadherin‐17 and SATB2 in cytology specimens: Do these new immunostains help in differentiating metastatic colorectal adenocarcinoma from adenocarcinomas of other origins?

“…Therefore, although uncommon, primary urinary bladder adenocarcinoma should be ruled out before attributing a diagnosis of colorectal adenocarcinoma to a cadherin‐17‐positive tumor. More recently, cadherin‐17 has shown a sensitivity of 81% for metanephric adenomas; however, these entities are morphologically distinct from MCA and therefore do not pose diagnostic difficulty.…”

DLC2 operates as a tumor suppressor gene in breast cancer via the RhoGTPase pathway

“…The percentage of stained cells was classified as follows: 0, no staining; 1, 1–25% staining; 2, 26–75% staining and 3, >75% staining. Final scores >4 were defined as positive and scores ≤4 as negative (12).…”

Chemotherapy Combined With Surgery in a Case With Metanephric Adenoma

“…Cadherin 17 (CDH17) is mainly expressed in normal intestinal and digestive tract tumors. Yakirevich et al ( 19 ) first suggested that CDH17 was a sensitive (81%) and highly specific (100%) marker of MA. Choueiri et al ( 20 ) identified BRAF V600E mutations in 26 of 29 MA cases, providing the first evidence that BRAF V600E mutations are present in 90% of MA cases and can be used as a potential diagnostic tool.…”