Diagnostic criteria for oncocytic renal neoplasms: a survey of urologic pathologists

Williamson, Sean R.; Gadde, Ramya; Trpkov, Kiril; Hirsch, Michelle S.; Srigley, John R.; Reuter, Victor E.; Cheng, Liang; Kunju, Lakshmi P.; Barod, Ravi; Rogers, Craig G.; Delahunt, Brett; Hes, Ondřej; Eble, John N.; Zhou, Ming; McKenney, Jesse K.; Martignoni, Guido; Fleming, Stewart; Grignon, David J.; Moch, Holger; Gupta, Nilesh

doi:10.1016/j.humpath.2017.03.004

Cited by 95 publications

(147 citation statements)

References 33 publications

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“…Fluorescence in situ hybridisation (FISH) can also be utilised, as multiple chromosome abnormalities typically occur in chromophobe RCCs, but this investigation is not necessarily routinely available. Even expert renal tumour pathologists report problems in this area, with only 64% of a group of world experts willing to definitively report benign oncocytomas on biopsy samples [65]. …”

Section: Resultsmentioning

confidence: 99%

WHO/ISUP classification, grading and pathological staging of renal cell carcinoma: standards and controversies

2018

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Section: Resultsmentioning

confidence: 99%

WHO/ISUP classification, grading and pathological staging of renal cell carcinoma: standards and controversies

2018

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“…Diagnosing renal tumours composed of oncocytic cells can often be challenging, because oncocytic morphology is found in a spectrum of entities. It is also currently recognised that there are oncocytic tumours that do not fit into any of the existing ‘oncocytic’ tumour categories . There is a need to define more clearly the morphological and immunohistochemical profiles of such tumours, as well as their genetics and clinical behaviour, in order to determine which tumours truly warrant the designation of carcinoma .…”

Section: Introductionmentioning

confidence: 99%

“…A frequent dilemma includes the distinction between the eosinophilic variant of chromophobe RCC (ChrRCC), a malignant tumour, and renal oncocytoma, a benign entity, that can be problematic solely on morphology . Although eosinophilic ChrRCC is a relatively indolent tumour, its distinction from oncocytoma is important because of the impact of the cancer diagnosis and the health‐care costs associated with patient management and surveillance . It is also well recognised that there are tumours with ‘borderline or intermediate’ features that are often reported descriptively, using usually ‘oncocytic’ and/or ‘unclassified’ as main diagnostic descriptors, often favouring one or the other .…”

Section: Introductionmentioning

confidence: 99%

“…The work‐up of cases in the spectrum of oncocytoma and ChrRCC often includes immunohistochemical evaluation for CD117 (KIT) and CK (cytokeratin) 7 . CD117 is typically positive in both eosinophilic ChrRCC and oncocytoma, as well as in some renal oncocytic tumours with ‘hybrid’ features . CD117 is generally helpful in differentiating these tumours from other renal neoplasms, which are typically CD117‐negative.…”

Section: Introductionmentioning

confidence: 99%

“…CD117 is generally helpful in differentiating these tumours from other renal neoplasms, which are typically CD117‐negative. Diffuse reactivity for CK7 is generally considered to favour ChrRCC, whereas CK7 labelling in oncocytoma is very limited and restricted to scattered individual cells, typically representing ≤ 5% of cells …”

Section: Introductionmentioning

confidence: 99%

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Low‐grade oncocytic tumour of kidney (CD117‐negative, cytokeratin 7‐positive): a distinct entity?

et al. 2019

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Aim To describe a group of distinct low‐grade oncocytic renal tumours that demonstrate CD117 negative/cytokeratin (CK) 7‐positive immunoprofile. Methods and results We identified 28 such tumours from four large renal tumour archives. We performed immunohistochemistry for: CK7, CD117, PAX8, CD10, AMACR, e‐cadherin, CK20, CA9, AE1/AE3, vimentin, BerEP4, MOC31, CK5/6, p63, HMB45, melan A, CD15 and FH. In 14 cases we performed array CGH, with a successful result in nine cases. Median patient age was 66 years (range 49–78 years) with a male‐to‐female ratio of 1:1.8. Median tumour size was 3 cm (range 1.1–13.5 cm). All were single tumours, solid and tan‐brown, without a syndromic association. On microscopy, all cases showed solid and compact nested growth. There were frequent areas of oedematous stroma with loosely arranged cells. The tumour cells had oncocytic cytoplasm with uniformly round to oval nuclei, but without significant irregularities, and showed only focal perinuclear halos. Negative CD117 and positive CK7 reactivity were present in all cases (in two cases there was focal and very weak CD117 reactivity). Uniform reactivity was found for PAX8, AE1/AE3, e‐cadherin, BerEP4 and MOC31. Negative stains included CA9, CK20, vimentin, CK5/6, p63, HMB45, Melan A and CD15. CD10 and AMACR were either negative or focally positive; FH was retained. On array CGH, there were frequent deletions at 19p13.3 (seven of nine), 1p36.33 (five of nine) and 19q13.11 (four of nine); disomic status was found in two of nine cases. On follow‐up (mean 31.8 months, range 1–118), all patients were alive with no disease progression. Conclusion Low‐grade oncocytic tumours that are CD117‐negative/CK7‐positive demonstrate consistent and readily recognisable morphology, immunoprofile and indolent behaviour.

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Ancillary studies in fine needle aspiration of the kidney

Renshaw

Gould

2018

Cancer Cytopathology

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An increasing number of renal cell carcinomas (RCCs) require ancillary studies for diagnosis. The majority of renal fine needle aspirates do not require ancillary studies. Among the most common useful stains are cytokeratin 7 (separating clear cell RCC [negative] from papillary RCC, clear cell papillary RCC, and multilocular cystic RCC [positive] as well as separating chromophobe RCC [diffusely positive] from oncocytoma [focally positive/negative]) and CD117 (separating chromophobe RCC and oncocytoma [positive] from granular variants of clear cell RCC [negative]). CD68 and keratin are helpful in distinguishing RCC from xanthogranulomatous pyelonephritis. HMB45 is useful in recognizing scant aspirates of angiomyolipoma. Less common subtypes of RCC may benefit from the use of more specialized ancillary studies (succinate dehydrogenase B, fumarate hydratase, tumor suppressor gene INI, OCT3/4). While the majority of renal fine needle aspirates can be accurately diagnosed based on morphology alone, improved subtyping and accuracy can be achieved with the use of immunohistochemical and molecular studies. Cancer Cytopathol 2018;000:000-000. © 2018 American Cancer Society.

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Diagnostic criteria for oncocytic renal neoplasms: a survey of urologic pathologists

Cited by 95 publications

References 33 publications

WHO/ISUP classification, grading and pathological staging of renal cell carcinoma: standards and controversies

WHO/ISUP classification, grading and pathological staging of renal cell carcinoma: standards and controversies

Low‐grade oncocytic tumour of kidney (CD117‐negative, cytokeratin 7‐positive): a distinct entity?

Ancillary studies in fine needle aspiration of the kidney

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