Chromophobe Cell Renal Carcinoma: Clinicopathological Features of 50 Cases

Crotty, Thomas B.; Farrow, George M.; Lieber, Michael M.

doi:10.1016/s0022-5347(01)66944-1

Cited by 251 publications

(141 citation statements)

References 16 publications

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“…[3][4][5][6] A DNA cytometric analysis of 43 chromophobe renal cell carcinomas revealed an aneuploid DNA index between 1.1 and 2.1 in 77% of the cases. 11 An aneuploid DNA index was found in three of five chromophobe renal cell carcinomas in another study. 10 All but one of the renal oncocytomas showed normal numbers of all the chromosomes studied and the exception showed loss only of chromosome 1.…”

Section: Discussionmentioning

confidence: 86%

“…9 The losses are sometimes so substantial that they can be detected by DNA flow cytometry. [10][11][12] Fluorescence in situ hybridization methods have been applied to only a few chromophobe renal cell carcinomas. Iqbal et al 13 used noncentromeric probes on touch imprint smears from six chromophobe renal cell carcinomas and found variable percentages of nuclei giving single signals.…”

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confidence: 99%

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Eosinophilic and classic chromophobe renal cell carcinomas have similar frequent losses of multiple chromosomes from among chromosomes 1, 2, 6, 10, and 17, and this pattern of genetic abnormality is not present in renal oncocytoma

et al. 2005

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That chromophobe renal cell carcinoma has an uncommon eosinophilic variant has been recognized for more than a decade. In sections stained with hematoxylin and eosin, the eosinophilic variant of chromophobe renal cell carcinoma and renal oncocytoma are similar in appearance. While it is well established that chromophobe renal cell carcinoma and renal oncocytoma have different patterns of genetic anomalies, little is known of the genetics of the eosinophilic variant of chromophobe renal cell carcinoma. This study was undertaken to elucidate the genetic lesions of eosinophilic chromophobe renal cell carcinoma and to compare them with those found in classic chromophobe renal cell carcinoma and in renal oncocytoma. A total of 29 renal neoplasms-nine eosinophilic chromophobe renal cell carcinomas, 10 classic chromophobe renal cell carcinomas, and 10 oncocytomas-were investigated by fluorescence in situ hybridization on 5 lm paraffinembedded tissue sections with centromeric probes for chromosomes 1, 2, 6, 10, and 17. Signals were counted in 100-200 neoplastic nuclei from each tumor. Chromophobe renal cell carcinomas frequently showed loss of chromosomes 1 (70% of classic, 67% of eosinophilic), 2 (90% classic, 56% eosinophilic), 6 (80% classic, 56% eosinophilic), 10 (60% classic, 44% eosinophilic), and 17 (90% classic, 78% eosinophilic); Among the classic chromophobe renal cell carcinomas, only one had no loss of any of the chromosomes, while 50% had loss of all five chromosomes. Among the eosinophilic chromophobe renal cell carcinomas, one of nine had no loss and 44% had loss of all five chromosomes. One oncocytoma had loss of chromosome 1. No other chromosomal loss was detected in the oncocytomas. In conclusion, losses of chromosomes 1, 2, 6, 10, and 17 are frequent in both eosinophilic and classic chromophobe renal cell carcinomas. Loss of chromosome 1 occurs occasionally in oncocytoma but losses of chromosomes 2, 6, 10, and 17 are not found in oncocytomas. When the differential diagnostic problem is oncocytoma vs eosinophilic chromophobe renal cell carcinoma, detection of losses of chromosomes 2, 6, 10, or 17 effectively excludes the diagnosis of oncocytoma and supports the diagnosis of chromophobe renal cell carcinoma.

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Section: Discussionmentioning

confidence: 86%

mentioning

confidence: 99%

Eosinophilic and classic chromophobe renal cell carcinomas have similar frequent losses of multiple chromosomes from among chromosomes 1, 2, 6, 10, and 17, and this pattern of genetic abnormality is not present in renal oncocytoma

et al. 2005

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“…3,4 However, recent investigations have demonstrated equivalent prognosis between chromophobe RCC and conventional clear-cell RCC when tumors of equivalent stage are compared. 5,6 Pathological tumor stage, tumor necrosis, and sarcomatoid change correlate with chromophobe RCC prognosis. 7 The benign renal oncocytoma is a histological mimic of chromophobe RCC, particularly its eosinophilic variant.…”

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confidence: 99%

Expression of the Na+/K+-transporting ATPase gamma subunit FXYD2 in renal tumors

et al. 2013

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Chromophobe renal cell carcinoma (RCC) is a form of renal cancer that may be confused with other eosinophilic renal tumors, including oncocytoma, type 2 papillary RCC, and clear-cell RCC with eosinophilic features. There are currently no robust markers to distinguish these neoplasms. Chromophobe RCC and renal oncocytoma are presumably derived from the distal nephron. FXYD2 is a distal tubule regulator of the trimeric Na þ / K þ -transporting ATPase that is enriched in kidney tissue. In this study, we investigated the expression of FXYD2 in normal human kidney, 27 chromophobe RCCs, 30 oncocytomas, 15 clear-cell RCCs, and 11 papillary RCCs. Immunohistochemical staining for FXYD2 showed diffuse, strong immunoreactivity in the basolateral membrane of distal tubules of normal human kidney. Ninety-six percent (26/27) of chromophobe RCCs were immunoreactive for FXYD2 in a distinctly membranous pattern. Twenty-five of these tumors showed at least focal 2 þ staining. In contrast, only 17% (5/30) of renal oncocytomas, 11% (2/15) of clear-cell RCCs, and 0% (0/11) of papillary RCCs displayed FXYD2 immunoreactivity. None of these cases showed Z2 þ FXYD2 staining. A subset of cases was confirmed as oncocytoma or chromophobe RCC using cytokeratin 7, colloidal iron, and interphase fluorescence in situ hybridization analysis of chromosomes 1, 2, 6, 10, and 17. Among this subset, 100% (7/7) of chromophobe RCCs were FXYD2 positive, whereas 17% (2/12) of oncocytomas were stained with FXYD2. The oncocytomas that stained with FXYD2 did so in a weak (1 þ ), patchy manner. In contrast, chromophobe RCCs showed Z2 þ staining in 86% (6/7) of these tumors. For comparison, this subset was also stained for kidney-specific cadherin (Ksp-cadherin). Ksp-cadherin showed positive staining in 100% (7/7) of chromophobe RCCs and 33% (4/12) of oncocytomas. This is the first report demonstrating the potential utility of FXYD2 immunohistochemistry in the diagnosis of chromophobe RCC.

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“…Chromophobe renal cell carcinomas have characteristic morphologic features of broad trabeculae of polygonal cells with clear to granular cytoplasm, prominent cell borders, wrinkled nuclear membranes, and frequent multinucleation (2)(3)(4). Ultrastructural examination of chromophobe cells containing prominent intracytoplasmic microvesicles between 250 -400 nm in diameter represents the traditional gold standard for diagnosis (5).…”

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confidence: 99%

Cytokeratins 7 and 20 Immunoreactivity in Chromophobe Renal Cell Carcinomas and Renal Oncocytomas

Kothari

Wheeler

et al. 2002

Mod Pathol

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Chromophobe renal cell carcinomas and renal oncocytomas share morphologic similarities and may present a diagnostic challenge on routine hematoxylin-eosin staining. Currently recommended additional studies of Hale's colloidal iron staining and electron microscopy are often difficult to interpret and technically challenging and may not be readily available. Previous studies have reported conflicting results with regard to the cytokeratin 7 staining pattern in chromophobe renal cell carcinomas and renal oncocytomas. Cytokeratin 20 expression in chromophobe renal cell carcinomas has not previously been studied. Formalin-fixed paraffinembedded tissue of 11 chromophobe renal cell carcinomas and 21 renal oncocytomas were retrieved from the archived files (1984 -2000) of four teaching hospitals. Of the 11 chromophobe renal cell carcinomas, eight stained positive (73%) for cytokeratin 7, one stained focally positive (9%), and two cases (18%) were completely negative. Cytokeratin 7 staining of the 21 oncocytomas revealed 4 positive (19%), 7 focally positive (33%), and 10 negative cases (48%). Cytokeratin 20 was uniformly negative on all 11 cases of chromophobe renal cell carcinomas and all 21 cases of oncocytomas. Cytokeratin 7 does not appear to show the consistent immunoreactivity in chromophobe renal cell carcinomas and renal oncocytomas, as has been previously suggested. Cytokeratin 20 immunostaining in chromophobe renal cell carcinomas and renal oncocytomas is uniformly negative. Despite the technical and interpretive challenges of Hale's colloidal iron, it is still the most useful stain in differentiating chromophobe renal cell carcinomas from renal oncocytomas.

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Chromophobe Cell Renal Carcinoma: Clinicopathological Features of 50 Cases

Abstract: Chromophobe cell carcinoma is a morphologically distinctive neoplasm with a favorable prognosis. Distinction from renal oncocytoma is important.

Cited by 251 publications

References 16 publications

Eosinophilic and classic chromophobe renal cell carcinomas have similar frequent losses of multiple chromosomes from among chromosomes 1, 2, 6, 10, and 17, and this pattern of genetic abnormality is not present in renal oncocytoma

Eosinophilic and classic chromophobe renal cell carcinomas have similar frequent losses of multiple chromosomes from among chromosomes 1, 2, 6, 10, and 17, and this pattern of genetic abnormality is not present in renal oncocytoma

Expression of the Na+/K+-transporting ATPase gamma subunit FXYD2 in renal tumors

Cytokeratins 7 and 20 Immunoreactivity in Chromophobe Renal Cell Carcinomas and Renal Oncocytomas

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