Fine-needle aspiration cytology of papillary renal cell carcinoma: The association with concomitant secondary malignancies

Lim, Jennifer C.; Wojcik, Eva M.

doi:10.1002/dc.20546

Cited by 15 publications

(17 citation statements)

References 18 publications

(41 reference statements)

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“…Surrounding tumor cells may also be arranged in tight clusters or spherules. 20,21 Papillary RCCs have a spectrum of morphologies, but have historically been subdivided into 2 main histologic subtypes, type 1 and type 2, which correlate with low-and high-grade morphologic features, respectively. In type 1 papillary RCCs, the cells are often small to medium in size and cuboidal in shape, and have uniform, round nuclei with even chromatin distribution, inconspicuous nucleoli, and scant to moderate amounts of cytoplasm.…”

Section: Cytomorphologic Features Of Rcc Subtypesmentioning

confidence: 99%

“…Type 2 papillary RCCs demonstrate larger cells and, similar to the cells of high-grade clear cell RCC, these cells display enlarged nuclei with prominent nucleoli and a moderate to abundant amount of granular cytoplasm. 17,21,22 Given that other RCC subtypes can occasionally demonstrate a papillary-like architecture on FNA, papillary architecture with true fibrovascular cores as well as ancillary studies, discussed below, are helpful in confirming a diagnosis of papillary RCC. Another helpful morphologic feature that one can identify in FNAs of papillary RCCs is foamy macrophages within papillae as well as in the background (Figure 4, B and C).…”

Section: Cytomorphologic Features Of Rcc Subtypesmentioning

confidence: 99%

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Diagnosis of Metastatic Renal Cell Carcinoma on Fine-Needle Aspiration Cytology

Lew

Foo

Roh³

2014

Archives of Pathology &Amp; Laboratory Medicine

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Fine-needle aspiration has assumed an increasingly important role in the diagnosis and management of patients with advanced stage cancer. Given its predilection for metastases to distant sites and organs at the time of presentation, metastatic renal cell carcinoma (RCC) is not infrequently encountered in the setting of fine-needle aspiration for initial diagnosis. In some instances, fine-needle aspiration may be the only opportunity to obtain diagnostic tissue to diagnose and subclassify RCC. Therefore, cytopathologists and cytotechnologists should be familiar with and recognize the cytomorphology of RCC and the ancillary studies that can be used to confirm and subclassify RCC. Herein, we describe a case of metastatic RCC initially diagnosed on fine-needle aspiration, discuss the cytomorphologic features of RCC subtypes, and review pertinent ancillary immunohistochemical and cytogenetic adjuncts.

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Section: Cytomorphologic Features Of Rcc Subtypesmentioning

confidence: 99%

Section: Cytomorphologic Features Of Rcc Subtypesmentioning

confidence: 99%

Diagnosis of Metastatic Renal Cell Carcinoma on Fine-Needle Aspiration Cytology

Lew

Foo

Roh³

2014

Archives of Pathology &Amp; Laboratory Medicine

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“…15 Because of the delicate cytoplasm, naked nuclei are often present. 17 They surmise that because these findings have not been described in clear cell RCC, they might be reliable findings in papillary RCC. The tumor cells are often arranged in sheets and clusters.…”

Section: Differential Diagnosesmentioning

confidence: 99%

“…16 Lim and Wojcik reported the presence of balls or three-dimensional clusters with smooth borders in their two cases. 17 They surmise that because these findings have not been described in clear cell RCC, they might be reliable findings in papillary RCC. Immunohistochemical stains supportive of the diagnosis will include immunoreactivity of the tumor cells with Cytokeratin 7, AMACR, CD10, RCC, vimentin, PAX8, and EMA.…”

Section: Differential Diagnosesmentioning

confidence: 99%

Fine‐needle aspiration findings of Xp11 translocation renal cell carcinoma metastatic to a hilar lymph node

Naili

Nicolas

Gorena

et al. 2017

Diagnostic Cytopathology

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Xp11 translocation renal cell carcinoma (RCC) is a specific type of renal cell carcinoma recently placed under the "MiT family translocation RCC" at the last 2013 ISUP Vancouver classification of renal neoplasia. This tumor contains variable proportions of clear cells and could easily mimic papillary RCC, clear cell type, and clear cell papillary RCC. Given the small number of published cytologic findings of this tumor, it could easily present as a diagnostic pitfall. We describe a case of a 23-year-old man with a history of prior nephrectomy who presented with multiple mediastinal lymphadenopathies on imaging surveillance follow-up. Fine-needle aspiration of the lymph node showed tumor cells with voluminous clear to eosinophilic cytoplasm, well-defined cell borders and hyperchromatic nuclei arranged in papillary architecture. Review of the prior nephrectomy specimen showed papillary cores surrounded by cells with voluminous clear to finely granular eosinophilic cytoplasm and distinct cell borders. Immunohistochemical stains performed on the nephrectomy specimen showed tumor positivity for CD10, E-cadherin, a-methylacyl coenzyme A racemase, and TFE3 supporting the diagnosis of Xp11 translocation renal cell carcinoma. Although this tumor was initially described predominantly in children, it could also occur in adults, as seen in this case. Familiarity with the cytologic findings of this tumor, use of immunohistochemical stains, or cytogenetic test to determine the type of gene fusion will be extremely useful in arriving at the correct diagnosis. Diagn. Cytopathol. 2017;45:456-462. © 2017 Wiley Periodicals, Inc.

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“…While FNAB has proved accurate for differentiating malignant from benign renal lesions, it is less reliable for subtyping renal carcinomas [7][8][9][10]. Immunohistochemistry has been shown to be helpful for accurate subtyping in core biopsies but there are only a few reports on the use of immunocytochemistry on FNAB samples of small series of renal tumors [11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 96%

Typing of renal tumors by morphological and immunocytochemical evaluation of fine needle aspirates

et al. 2011

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Image-guided fine needle aspiration biopsy (FNAB) of renal masses can accurately evaluate malignancy. Adjunct methods are needed for accurate typing of renal cell carcinomas (RCC) and benign neoplasms. Cytopathological diagnoses of 79 routine ultrasound-guided FNAB of renal lesions were compared to consequent histological diagnosis and size of tumors. Cytology samples were sufficient for immunocytochemical subtyping in 43 cases (54.4%). The median tumor size was 2.8 cm, with 57 cases (76%) smaller than or equal to 4 cm. When a panel of immunocytochemical stainings (vimentin, CK7, CD117, P504S) was applied, accurate diagnoses were obtained in 11/12 (91.7%) of clear cell RCC (CRCC), 14/17 (82.3%) of papillary RCC (PRCC) and 5/7 (71.4%) of chromophobe RCC (ChRCC), respectively. Substantial cell pleomorphism with unusual immunostainings led to erroneous diagnosis of pheochromocytoma in CRCC with eosinophilic cytoplasm. Only 30% of CRCC were correctly diagnosed in the group without immunostaining, seven were suspicious for CRCC, and the remainder had unrepresentative material for CRCC. Cytopathological diagnoses were less accurate in oncocytomas (n=11), regardless of immunocytochemical staining. Cystic nephromas (n=2) and MEST (n=1) were overdiagnosed as suspicious and positive for PRCC, respectively, with immunocytochemical staining not assisting in correct diagnosis. RCC can be accurately typed as CRCC, PRCC or ChRCC in fine needle aspirates in a routine clinical setting if the cellular material is sufficient and a panel of antibodies is used (vimentin, CK7, P504S, CD117). The classification of oncocytomas and cystic nephromas is not reliable since atypical morphology and immunocytochemical reactions overlap with RCC.

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Fine-needle aspiration cytology of papillary renal cell carcinoma: The association with concomitant secondary malignancies

Cited by 15 publications

References 18 publications

Diagnosis of Metastatic Renal Cell Carcinoma on Fine-Needle Aspiration Cytology

Diagnosis of Metastatic Renal Cell Carcinoma on Fine-Needle Aspiration Cytology

Fine‐needle aspiration findings of Xp11 translocation renal cell carcinoma metastatic to a hilar lymph node

Typing of renal tumors by morphological and immunocytochemical evaluation of fine needle aspirates

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