Metanephric adenoma and solid variant of papillary renal cell carcinoma: common and distinctive features

Padilha, Mariana Mantoan; Billis, Athanase; Allende, Daniela S.; Zhou, Ming; Magi‐Galluzzi, Cristina

doi:10.1111/his.12106

Cited by 52 publications

(50 citation statements)

References 45 publications

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“…WT-1 positivity is of great utility in ruling out s-PRCC, but does not help in distinguishing MA from e-WT. CD57 is frequently expressed in MA (1,4,7), although in our study CD57 was moderate to strongly positive in 35% of e-WT and 13% of s-PRCC. Similar to our findings, CD57 positivity was reported in 12.5% of WT (8), in mature appearing tubules of WT (4), and in 70% of s-PRCC (7).…”

Section: Discussioncontrasting

confidence: 73%

“…A panel of immunostains including WT-1, CD57, and AMACR has been shown to be helpful in distinguishing MA from its mimics, namely, e-WT and s-PRCC (4,7,8). Our findings of high WT-1 sensitivity for e-WT and MA are in complete agreement with several previous reports (4,7,8). WT-1 positivity is of great utility in ruling out s-PRCC, but does not help in distinguishing MA from e-WT.…”

Section: Discussionmentioning

confidence: 99%

“…MAs are usually diffusely positive for WT-1 and CD57, and typically negative for alpha-methylacyl CoA racemase (AMACR) (4,7,8). These markers are helpful in distinguishing MA from e-WT and s-PRCC, but in some cases the diagnosis may be challenging since there is overlap in the immunophenotype of these tumors.…”

Section: Introductionmentioning

confidence: 99%

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Cadherin 17 Is a Sensitive and Specific Marker for Metanephric Adenoma

Yakirevich

Magi‐Galluzzi²,

Grada

et al. 2015

American Journal of Surgical Pathology

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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.

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Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

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Cadherin 17 Is a Sensitive and Specific Marker for Metanephric Adenoma

Yakirevich

Magi‐Galluzzi²,

Grada

et al. 2015

American Journal of Surgical Pathology

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“…These marker profiles may be useful in differentiating MA from papillary RCC and Wilms tumour. 9 Clinically, MA seemed to have a distinctive female preponderance; nevertheless, no gender difference was found in our series. Most cases were asymptomatic and were detected incidentally on imaging performed for other indications.…”

Section: Radiological and Pathological Correlationcontrasting

confidence: 68%

CT imaging spectrum and the histopathological features of adult metanephric adenoma

Song

et al. 2015

BJR

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Metanephric adenoma (MA) was first identified in 1979 and has been subsequently classified within the group of metanephric tumours, which comprise MAs, metanephric adenofibromas and metanephric stromal tumours. 1 The wide use of ultrasound, CT and MRI has led to an increase of incidentally discovered renal masses, including benign and malignant renal tumours. However, there are no unique and reliable radiological features for the differentiation of MA from renal cell carcinoma (RCC) and other benign renal tumours except for angioleiomyolipoma. There are no well-admitted criteria so this makes a diagnosis difficult; therefore, we performed the investigation focusing on CT imaging characteristics and corresponding pathological findings in order to establish CT diagnostic criteria of MA as the reference standard. METHODS AND MATERIALS Design and patientsThe clinical and radiological data were retrieved from archival files and were retrospectively analysed. Our institutional review board of The Second Hospital of Tianjin Medical University and Tianjin Union Medicine Center approved this study and waived the informed consent requirement. Data collected included age, gender, clinical presentation, preoperative tumour characteristics (size, location, diameter, nearness to collecting system, growth pattern etc) and final pathological findings. In total, 18 patients (9 males and 9 females; mean age, 50 years; range, 18-66 years) between

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“…Briefly, renal carcinoid typically express neuroendocrine markers (synaptophysin, chromogranin, CD56) and may be positive for CD99 [1]. Wilms' tumor is positive for WT1 and usually negative for chromogranin and synaptophysin [14]. Primitive neuroectodermal tumor of the kidney is immunoreactive for CD99 and negative for WT1 [15].…”

Section: Discussionmentioning

confidence: 99%

Small Cell Variant of Renal Oncocytoma – a Case Report of Unusual Histopathologic Entity

Bartoš

2017

Galician med. j.

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Renal oncocytoma (RO) accounts for 3-7% of all renal cells tumors. It typically consistes of large eosinophilic cells (oncocytes) with abundant cytoplasm, which constitute the crucial diagnostic feature. In 2001, the Czeck authors first described an unusual small cell variant of RO and untill now, only a few reports of such cases have been published. In the current article, the author presents an additional new case. 40-year old male with macroscopic hematuria as a clinical symptom was diagnosed to have solitary tumor in the upper third of the right kidney. He underwent a nephrectomy. On light microscopy, the tumor was predominantly composed of uniform small cells ( " oncoblasts") with scant cytoplasm, hyperchromic nuclei and high nuclear-to-cytoplasmic ratio. In addition, it also contained characteristic oncocytes typical for oncocytoma. Tumor was strongly immunoreactive for EMA, sporadically positive for CK7 and negative for RCC antigen, vimentin, S100, WT1, chromogranin and synaptophysin. Proliferative activity did not exceed 1% and mitotic activity was virtually absent. No necrosis or aggressive growth features were found. The spectrum of histopathologic and immunohistochemical findings was consistent with a diagnosis of small cell variant of RO. The author focus on histopathological aspects and differential diagnostic pitfalls of this unique lesion.

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Metanephric adenoma and solid variant of papillary renal cell carcinoma: common and distinctive features

Abstract: Despite overlapping features, careful morphological and architectural evaluation should result in accurate diagnosis of most MA and s-PRCC. In challenging cases, IHC stains for WT1, EMA and AMACR may help in distinguishing these two entities.

Cited by 52 publications

References 45 publications

Cadherin 17 Is a Sensitive and Specific Marker for Metanephric Adenoma

Cadherin 17 Is a Sensitive and Specific Marker for Metanephric Adenoma

CT imaging spectrum and the histopathological features of adult metanephric adenoma

Small Cell Variant of Renal Oncocytoma – a Case Report of Unusual Histopathologic Entity

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