Chromophobe cell renal carcinoma and its variants—a report on 32 cases

Abstract

This paper reports on 32 chromophobe cell renal carcinomas observed in 697 renal cell cancers (RCC) of adults (peak in the sixth decade of life). The chromophobe cell-type differs from other types of RCC macroscopically, the cut-surface being predominantly of grey-beige colour. Histologically, there are two variants: one is the typical (light) variant (n = 22) and the other is eosinophilic (n = 10). Both variants have in common (a) reaction of the cytoplasm with Hale's acid iron colloid; (b) electron microscopic detection of cytoplasmic microvesicles (150-300 nm), frequently with 'inner vesicles', and (c) low glycogen content in comparison with the clear cell carcinoma. Immunocytochemical investigations on the intermediate filaments show a positive reaction for cytokeratins No. 18 (uniformly) and Nos. 7 and 19 (to varying extents) for both variants, whereas vimentin was not found in any of these carcinomas, in contrast to the clear-cell type. The cytomorphological grading revealed predominantly G II tumours. A lymph node metastasis was found in one patient. On the basis of the mortality curves determined, the prognosis for patients with chromophobe cell carcinomas is more favourable than that of the clear-cell type. In terms of differential diagnosis, on the one hand, the typical (light) variant of the chromophobe cell RCC must be delimited from the clear-cell RCC, and on the other hand, the eosinophilic variant must be distinguished from the chromophilic or 'granular' RCC. Microscopic, histological, histochemical, electron microscopic, and intermediate filament analysis results document that the chromophobe cell type of RCC is a distinct entity. The implications for the nomenclature of RCC, especially with regard to the 'granular' type, are discussed.

Parvalbumin Is Constantly Expressed in Chromophobe Renal Carcinoma

“…For this reason, the implementation of morphological analysis with histochemical and immunohistochemical stains has been attempted by various authors (10 -14). However, the number of useful stains is limited, and the only helpful immunohistochemical finding consistently reported on chromophobe carcinoma is the absence of staining for vimentin (5,14,24).…”

“…It has been suggested that the cells of chromophobe renal carcinoma are related to the normal intercalated cells of the collecting ducts, as it is ultrastructurally characterized by the presence of numerous cytoplasmic vesicles resembling those observed in these cells (5)(6)(7). Two subtypes of chromophobe carcinoma have been described, a typical variant and an eosinophilic variant (5).…”

“…It has been suggested that the cells of chromophobe renal carcinoma are related to the normal intercalated cells of the collecting ducts, as it is ultrastructurally characterized by the presence of numerous cytoplasmic vesicles resembling those observed in these cells (5)(6)(7). Two subtypes of chromophobe carcinoma have been described, a typical variant and an eosinophilic variant (5). The first has to be distinguished from conventional (clear cell) carcinoma, whereas the second must be separated from those tumors characterized by cells with granular cytoplasm, such as renal oncocytomas, conventional (clear cell) carcinomas with diffuse areas of granular cells, as well as some rare forms of papillary renal cell carcinoma.…”

Fine-needle aspiration biopsy of chromophobe renal cell carcinoma and oncocytoma

“…2 The prognosis for ChRCC is intermediate between renal oncocytoma (RO) and clear cell renal carcinoma. [3][4][5] The cancer staging system used for renal tumors including RO and ChRCC carcinoma is that of the American Joint Committee on Cancer. 6 To our knowledge the cytologic features of only a limited number of cases of ChRCC have been described to date.…”

Renal cell neoplasm of oncocytosis: a type of unclassified renal cell carcinoma

“…This type of tumor does not show the chromosomal aberrations of 3p that is characteristic of renal clear cell carcinoma. Histologically, there are 2 variants: one is the typical variant and the other is eosinophilic [5]. Chromophobe cells show a positive reaction for the colloidal iron staining [6].…”