Role of Immunohistochemistry in Diagnosing Renal Neoplasms: When Is It Really Useful?

Shen, Steven S.; Truong, Luan D.; Scarpelli, Marina; López-Beltrán, Antonio

doi:10.5858/arpa.2011-0472-ra

Cited by 107 publications

(105 citation statements)

References 94 publications

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“…Due to the rarity of this presentation, full immunohistochemical profiling is the approach for clarifying this ambiguity. The positivity of expression of low molecular weight CAM 5.2, PAX 8, CD 10, vimentin, CAIX and RCC marker and the negativity of CK 7, CK 20, TTF1 and S100 highly supports the proposed diagnosis of mRCC [13,14]. The genomic alterations detected further favored the diagnosis; recent data implicated PBRM1 to be associated with clear cell RCC16 as well as alterations in CDKN2A [15][16][17].…”

Section: Discussionmentioning

confidence: 84%

Metastatic renal cell carcinoma with undetectable renal mass presenting as lymphadenopathy

2016

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Renal cell carcinoma has the ability to metastasize to any organ; about 16 % of affected patients present initially with metastasis. However, it is rare for this tumor to present with metastasis from an unidentified primary. The current use of immunohistochemistry and molecular genetics has enabled clinicians to reach a precise diagnosis. It has been hypothesized that the treatment protocol for metastatic renal cell carcinoma can be applied to cases with undetectable primary. In this paper, a novel case of metastatic renal cell carcinoma presenting with lymphadenopathy with no evidence of a primary renal lesion is reported from Kuwait cancer center.

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Section: Discussionmentioning

confidence: 84%

Metastatic renal cell carcinoma with undetectable renal mass presenting as lymphadenopathy

2016

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“…Biopsy of the primary renal mass allows for histologic investigation and immunohistochemical staining to establish a diagnosis in correlation with clinical and radiologic findings. Tumour type-specific immunohistochemical profiles for primary rccs are largely conserved in their metastatic deposits 6 . Positive staining for cd10 and a combination of vimentin and cytokeratins is helpful in distinguishing renal cell tumours from nonrenal-cell tumours 6 .…”

Section: Discussionmentioning

confidence: 99%

“…Tumour type-specific immunohistochemical profiles for primary rccs are largely conserved in their metastatic deposits 6 . Positive staining for cd10 and a combination of vimentin and cytokeratins is helpful in distinguishing renal cell tumours from nonrenal-cell tumours 6 . All rccs also stain negatively for cytokeratin 20 6 .…”

Section: Discussionmentioning

confidence: 99%

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Metastatic Renal Cell Carcinoma without Evidence of a Primary Renal Tumour

et al. 2014

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new cases of rcc and 13,500 deaths every year are attributed to this type of renal cancer 1 . In recent decades, the incidence of rcc has been increasing, and the average tumour size at diagnosis has been declining 2 . Those trends are partially attributable to the widespread use of noninvasive abdominal imaging modalities, which have allowed for more incidental findings of asymptomatic tumours. Renal cell carcinoma is about 50% more common in men than in women, and it is unusual in patients under 40 years of age 1 . Several distinct subtypes of rcc have been identified, including the clear cell, papillary, chromophobe, and collecting duct variants 3 . Clear cell rcc, the most common subtype, accounts for 75% of all rcc tumours 2 .Metastatic rcc (mrcc) generally presents with evidence of a primary renal mass, except in cases of metachronous mrcc after nephrectomy for rcc. Here, we present two unusual cases of metastatic clear cell rcc with no evidence of a primary renal tumour. CASE DESCRIPTIONS Patient 1A 70-year-old man was admitted for a fall-induced hip fracture and subsequently underwent arthroplasty. He was readmitted to hospital 8 months later for hypercalcemia and confusion. At that time, computerized tomography (ct) imaging showed bilateral native kidneys in situ; bony lesions in the left scapula, seventh right rib, fifth left rib, and left sternoclavicular joint; and two nodules in the upper lobe of the left lung. There was also destruction of the left pubo-iliac bone from a multi-lobulated lesion (measuring 11 cm) replacing bone, and no evidence of soft-tissue disease (Figure 1).An ABSTRACTAlthough metastases are common in patients with renal cell carcinoma (rcc), it is extremely rare for patients to present with metastatic rcc (mrcc) without evidence of a primary mass in the kidney. Two cases of mrcc with no detectable primary renal mass are reported here. Both patients had bilateral native kidneys in situ and no significant prior urologic history. The first patient presented with a hip fracture and was found to have multiple radiologic bony and lung metastases. Biopsy of a mass involving the pubic bone demonstrated clear cell mrcc. Multiple scans by computed tomography (ct) and confirmatory imaging by magnetic resonance demonstrated no renal mass. This first patient had disease stabilization for 18 months on sunitinib and was still alive at last follow-up. The second patient was diagnosed with clear-cell mrcc after thickened synovium was discovered and biopsied during a knee arthroplasty. Multiple scans by ct in this second patient demonstrated no primary renal mass. Sunitinib and radiotherapy to the knee lesion were initiated, but unfortunately, the patient deteriorated clinically and passed away from disease progression shortly after diagnosis. Because of the rare nature of these cases, a standardized course of action has not yet been established. However, we hypothesize that it is reasonable to manage metastases in these patients by following established mrcc protocols. KEY WORDSMetastatic renal...

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“…In such cases, immunohistochemistry plays an important role in clinching the origin of the tumor cells, as we found in our case. Clear cell renal cell carcinoma usually stains positive for vimentin, cytokeratin antibodies (AE1/AE3), CD10, renal cell carcinoma marker (RCCM), PAX2, PAX8, and carbonic anhydrase IX (CAIX), and stains negative for cytokeratins (CK7, CK 20), high-molecular-weight cytokeratin (HMWCK), CD 117 and parvalbumin [11].…”

Section: Discussionmentioning

confidence: 99%

Role of immunohistochemistry in metastatic clear cell variant of follicular thyroid carcinoma: A case report

Vaidya¹,

Vaithianathan²,

Manickam³

et al. 2017

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. Conclusion: Clear cell variant of follicular thyroid carcinoma is a very rare condition, hence a high index of suspicion is essential for diagnosis. The importance of performing a detailed physical examination cannot be more emphasized as small thyroid lesion like in this case can be easily missed, leading to a delay in diagnosis.

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Role of Immunohistochemistry in Diagnosing Renal Neoplasms: When Is It Really Useful?

Cited by 107 publications

References 94 publications

Metastatic renal cell carcinoma with undetectable renal mass presenting as lymphadenopathy

Metastatic renal cell carcinoma with undetectable renal mass presenting as lymphadenopathy

Metastatic Renal Cell Carcinoma without Evidence of a Primary Renal Tumour

Role of immunohistochemistry in metastatic clear cell variant of follicular thyroid carcinoma: A case report

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