Clear cell renal cell carcinoma - Revision history

Michael: /* Microscopic */

2025-03-07T03:22:19Z

Microscopic

← Older revision		Revision as of 03:22, 7 March 2025
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	*[[Benign clear cell clusters of the kidney]].		*[[Benign clear cell clusters of the kidney]].
	*[[Renal cell carcinoma with fibromyomatous stroma]].		*[[Renal cell carcinoma with fibromyomatous stroma]].
	*[[Hemangioblastoma of the kidney]] - especially in [[~~Von~~ Hippel-Lindau disease]].		*[[Hemangioblastoma of the kidney]] - especially in [[von Hippel-Lindau disease]].
	**S-100 +ve, inhibin +ve, PAX-8+ve, EMA -ve, CA9 -ve.		**S-100 +ve, inhibin +ve, PAX-8+ve, EMA -ve, CA9 -ve.

Michael at 03:21, 7 March 2025

2025-03-07T03:21:49Z

← Older revision		Revision as of 03:21, 7 March 2025
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	\| Micro = solid or [[trabecular]] pattern, polygonal cells usually with clear cytoplasm (may be eosinophilic - esp. in high grade tumours), central nucleus, delicate branching vasculature (chicken wire-like), +/-hyaline bodies		\| Micro = solid or [[trabecular]] pattern, polygonal cells usually with clear cytoplasm (may be eosinophilic - esp. in high grade tumours), central nucleus, delicate branching vasculature (chicken wire-like), +/-hyaline bodies
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[chromophobe renal cell carcinoma]], [[clear cell papillary renal cell tumour]], [[Xp11.2 translocation carcinoma]], [[ELOC-mutated renal cell carcinoma]], [[renal cell carcinoma with fibromyomatous stroma]], [[benign clear cell clusters of the kidney]], [[alveolar soft part sarcoma]], [[adrenocortical carcinoma]]		\| LMDDx = [[chromophobe renal cell carcinoma]], [[clear cell papillary renal cell tumour]], [[Xp11.2 translocation carcinoma]], [[ELOC-mutated renal cell carcinoma]], [[renal cell carcinoma with fibromyomatous stroma]], [[benign clear cell clusters of the kidney]], [[alveolar soft part sarcoma]], [[adrenocortical carcinoma]], [[hemangioblastoma of the kidney]]
	\| Stains = PAS +ve, PAS-D -ve, [[Hale's colloidal iron stain]] -ve		\| Stains = PAS +ve, PAS-D -ve, [[Hale's colloidal iron stain]] -ve
	\| IHC = [[CA9]] +ve, CK7 -ve, CK20 -ve, TFE3 -ve, PAX8 +ve, vimentin +ve		\| IHC = [[CA9]] +ve, CK7 -ve, CK20 -ve, TFE3 -ve, PAX8 +ve, vimentin +ve
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	*[[Benign clear cell clusters of the kidney]].		*[[Benign clear cell clusters of the kidney]].
	*[[Renal cell carcinoma with fibromyomatous stroma]].		*[[Renal cell carcinoma with fibromyomatous stroma]].
			*[[Hemangioblastoma of the kidney]] - especially in [[Von Hippel-Lindau disease]].
			**S-100 +ve, inhibin +ve, PAX-8+ve, EMA -ve, CA9 -ve.

	===Images===		===Images===

Michael at 17:23, 6 March 2025

2025-03-06T17:23:10Z

← Older revision		Revision as of 17:23, 6 March 2025
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	\| Micro = solid or [[trabecular]] pattern, polygonal cells usually with clear cytoplasm (may be eosinophilic - esp. in high grade tumours), central nucleus, delicate branching vasculature (chicken wire-like), +/-hyaline bodies		\| Micro = solid or [[trabecular]] pattern, polygonal cells usually with clear cytoplasm (may be eosinophilic - esp. in high grade tumours), central nucleus, delicate branching vasculature (chicken wire-like), +/-hyaline bodies
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[chromophobe renal cell carcinoma]], [[clear cell papillary renal cell ~~carcinoma~~]], [[Xp11.2 translocation carcinoma]], [[~~adrenocortical~~ carcinoma]], [[alveolar soft part sarcoma]]		\| LMDDx = [[chromophobe renal cell carcinoma]], [[clear cell papillary renal cell tumour]], [[Xp11.2 translocation carcinoma]], [[ELOC-mutated renal cell carcinoma]], [[renal cell carcinoma with fibromyomatous stroma]], [[benign clear cell clusters of the kidney]], [[alveolar soft part sarcoma]], [[adrenocortical carcinoma]]
	\| Stains = [[Hale's colloidal iron stain]] -ve		\| Stains = PAS +ve, PAS-D -ve, [[Hale's colloidal iron stain]] -ve
	\| IHC = [[CA9]] +ve, CK7 -ve, CK20 -ve, TFE3 -ve, PAX8 +ve, vimentin +ve		\| IHC = [[CA9]] +ve, CK7 -ve, CK20 -ve, TFE3 -ve, PAX8 +ve, vimentin +ve
	\| EM =		\| EM =

Michael: /* Stains */

2025-03-06T17:21:09Z

Stains

← Older revision		Revision as of 17:21, 6 March 2025
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	==Stains==		==Stains==
			*PAS +ve.
			*PAS-D -ve.<ref>{{cite journal \|authors=Kolečková M, Tichý T, Melichar B, Veverková L, Hes O, Kolek V, Kolář Z \|title=Metastatic Clear Cell Renal Carcinoma Without Evidence of a Primary Renal Tumour Mimicking Advanced Stage of Malignant Lung Tumour \|journal=Klin Onkol \|volume=32 \|issue=Supplementum1 \|pages=154–156 \|date=2019 \|pmid=31064187 \|doi= \|url=}}</ref><ref>{{cite journal \|authors=Liu S, Liu H, Weng B, Hou S \|title=Case report: Tongue metastasis as an initial sign of clear cell renal cell carcinoma and its prognosis \|journal=Front Oncol \|volume=14 \|issue= \|pages=1473211 \|date=2024 \|pmid=39931206 \|pmc=11807832 \|doi=10.3389/fonc.2024.1473211 \|url=}}</ref>
	*Hale's colloidal iron -ve.		*Hale's colloidal iron -ve.
	**+ve in [[chromophobe RCC]].		**+ve in [[chromophobe RCC]].
	*PAS +ve.
	*PAS-D -ve.


	Note:		Note:

Michael at 17:19, 6 March 2025

2025-03-06T17:19:10Z

← Older revision		Revision as of 17:19, 6 March 2025
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	DDx:		DDx:
	*[[Chromophobe renal cell carcinoma]].		*[[Chromophobe renal cell carcinoma]].
	*[[Clear cell papillary renal cell carcinoma]].		**Chromophobe: "translucent" (NOT quite clear), reticulated, Hale's colloidal iron stain+, CK7+ (cell membrane).
			*[[Clear cell papillary renal cell tumour]].
			*[[ELOC-mutated renal cell carcinoma]].
	*[[Xp11.2 translocation carcinoma]].		*[[Xp11.2 translocation carcinoma]].
	*[[Adrenocortical carcinoma]] (ACC)		*[[Adrenocortical carcinoma]] (ACC).
	**EMA -ve, CKs mostly -ve, inhibin +ve (neg. in RCC).<ref name=Ref_GUP285>{{Ref GUP\|285}}</ref>		**EMA -ve, CKs mostly -ve, inhibin +ve (neg. in RCC).<ref name=Ref_GUP285>{{Ref GUP\|285}}</ref>
	*[[Alveolar soft part sarcoma]].		*[[Alveolar soft part sarcoma]].
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	*[[Epithelioid angiomyolipoma]].		*[[Epithelioid angiomyolipoma]].
	*[[Benign clear cell clusters of the kidney]].		*[[Benign clear cell clusters of the kidney]].
			*[[Renal cell carcinoma with fibromyomatous stroma]].

	===Images===		===Images===
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	Note:		Note:
	*''[[Hale's colloidal iron]]'' does not stain iron... it stains hemosiderin.<ref>Latta. 27 January 2009.</ref>		*''[[Hale's colloidal iron]]'' does not stain iron... it stains hemosiderin.<ref>Latta. 27 January 2009.</ref>

	~~Clear cell vs. chromophobe:~~
	*Chromophobe: "translucent" (NOT quite clear), reticulated, Hale's colloidal iron stain+, CK7+ (cell membrane).

	==IHC==		==IHC==

Michael: /* Stains */

2025-03-06T17:17:20Z

Stains

← Older revision		Revision as of 17:17, 6 March 2025
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	*Hale's colloidal iron -ve.		*Hale's colloidal iron -ve.
	**+ve in [[chromophobe RCC]].		**+ve in [[chromophobe RCC]].
			*PAS +ve.
			*PAS-D -ve.

	Note: ''[[Hale's colloidal iron]]'' does not stain iron... it stains hemosiderin.<ref>Latta. 27 January 2009.</ref>
			Note:
			*''[[Hale's colloidal iron]]'' does not stain iron... it stains hemosiderin.<ref>Latta. 27 January 2009.</ref>

	Clear cell vs. chromophobe:		Clear cell vs. chromophobe:

Michael: benign clear cell clusters

2024-01-22T16:14:07Z

benign clear cell clusters

← Older revision		Revision as of 16:14, 22 January 2024
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	*[[Adrenal gland]], normal cortex - wispy, vacuolated.		*[[Adrenal gland]], normal cortex - wispy, vacuolated.
	*[[Epithelioid angiomyolipoma]].		*[[Epithelioid angiomyolipoma]].
			*[[Benign clear cell clusters of the kidney]].

	===Images===		===Images===

Michael: /* Resection */

2018-08-28T15:54:54Z

Resection

← Older revision		Revision as of 15:54, 28 August 2018
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	*The surgeon wants the diagnosis and margin status; thus, these are included in the diagnosis line with the tumour stage.		*The surgeon wants the diagnosis and margin status; thus, these are included in the diagnosis line with the tumour stage.

			<pre>
			Left Kidney, Radical Nephrectomy:
			- CLEAR CELL RENAL CELL CARCINOMA.
			-- Margins clear.
			-- Please see synoptic report.
			</pre>

			====Block letters====
	<pre>		<pre>
	KIDNEY, LEFT, NEPHRECTOMY:		KIDNEY, LEFT, NEPHRECTOMY:

Michael: /* General */

2018-08-09T13:37:50Z

General

← Older revision		Revision as of 13:37, 9 August 2018
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	*Various drugs.		*Various drugs.
	*Targeted therapies.		*Targeted therapies.
	**[[Tyrosine kinase inhibitors]] (e.g. sunitinib, sorafenib).<ref name=pmid25467013>{{Cite journal \| last1 = Elaidi \| first1 = R. \| last2 = Harbaoui \| first2 = A. \| last3 = Beuselinck \| first3 = B. \| last4 = Eymard \| first4 = JC. \| last5 = Bamias \| first5 = A. \| last6 = De Guillebon \| first6 = E. \| last7 = Porta \| first7 = C. \| last8 = Vano \| first8 = Y. \| last9 = Linassier \| first9 = C. \| title = Outcomes from second-line therapy in long-term responders to first-line tyrosine kinase inhibitor in clear-cell metastatic renal cell carcinoma. \| journal = Ann Oncol \| volume = 26 \| issue = 2 \| pages = 378-85 \| month = Feb \| year = 2015 \| doi = 10.1093/annonc/mdu552 \| PMID = 25467013 }}</ref><ref name=pmid21484781>{{Cite journal \| last1 = Verma \| first1 = J. \| last2 = Jonasch \| first2 = E. \| last3 = Allen \| first3 = P. \| last4 = Tannir \| first4 = N. \| last5 = Mahajan \| first5 = A. \| title = Impact of tyrosine kinase inhibitors on the incidence of brain metastasis in metastatic renal cell carcinoma. \| journal = Cancer \| volume = 117 \| issue = 21 \| pages = 4958-65 \| month = Nov \| year = 2011 \| doi = 10.1002/cncr.26138 \| PMID = 21484781 }}</ref>		**[[Tyrosine kinase inhibitors]] (e.g. [[sunitinib]], sorafenib).<ref name=pmid25467013>{{Cite journal \| last1 = Elaidi \| first1 = R. \| last2 = Harbaoui \| first2 = A. \| last3 = Beuselinck \| first3 = B. \| last4 = Eymard \| first4 = JC. \| last5 = Bamias \| first5 = A. \| last6 = De Guillebon \| first6 = E. \| last7 = Porta \| first7 = C. \| last8 = Vano \| first8 = Y. \| last9 = Linassier \| first9 = C. \| title = Outcomes from second-line therapy in long-term responders to first-line tyrosine kinase inhibitor in clear-cell metastatic renal cell carcinoma. \| journal = Ann Oncol \| volume = 26 \| issue = 2 \| pages = 378-85 \| month = Feb \| year = 2015 \| doi = 10.1093/annonc/mdu552 \| PMID = 25467013 }}</ref><ref name=pmid21484781>{{Cite journal \| last1 = Verma \| first1 = J. \| last2 = Jonasch \| first2 = E. \| last3 = Allen \| first3 = P. \| last4 = Tannir \| first4 = N. \| last5 = Mahajan \| first5 = A. \| title = Impact of tyrosine kinase inhibitors on the incidence of brain metastasis in metastatic renal cell carcinoma. \| journal = Cancer \| volume = 117 \| issue = 21 \| pages = 4958-65 \| month = Nov \| year = 2011 \| doi = 10.1002/cncr.26138 \| PMID = 21484781 }}</ref>
	**Anti-VEGF antibodies (e.g. bevacizumab).<ref name=pmid21330923>{{Cite journal \| last1 = Singer \| first1 = EA. \| last2 = Gupta \| first2 = GN. \| last3 = Srinivasan \| first3 = R. \| title = Update on targeted therapies for clear cell renal cell carcinoma. \| journal = Curr Opin Oncol \| volume = 23 \| issue = 3 \| pages = 283-9 \| month = May \| year = 2011 \| doi = 10.1097/CCO.0b013e32834479c0 \| PMID = 21330923 }}</ref>		**Anti-VEGF antibodies (e.g. bevacizumab).<ref name=pmid21330923>{{Cite journal \| last1 = Singer \| first1 = EA. \| last2 = Gupta \| first2 = GN. \| last3 = Srinivasan \| first3 = R. \| title = Update on targeted therapies for clear cell renal cell carcinoma. \| journal = Curr Opin Oncol \| volume = 23 \| issue = 3 \| pages = 283-9 \| month = May \| year = 2011 \| doi = 10.1097/CCO.0b013e32834479c0 \| PMID = 21330923 }}</ref>

Michael: /* CCRCC versus chromophobe RCC */

2017-10-20T16:52:24Z

CCRCC versus chromophobe RCC

← Older revision		Revision as of 16:52, 20 October 2017
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	ISUP recommends:<ref name=pmid25025364 >{{cite journal \|author=Amin MB, Epstein JI, Ulbright TM, ''et al.'' \|title=Best practices recommendations in the application of immunohistochemistry in urologic pathology: report from the international society of urological pathology consensus conference \|journal=Am. J. Surg. Pathol. \|volume=38 \|issue=8 \|pages=1017–22 \|year=2014 \|month=August \|pmid=25025364 \|doi=10.1097/PAS.0000000000000254 \|url=}}</ref>		ISUP recommends:<ref name=pmid25025364 >{{cite journal \|author=Amin MB, Epstein JI, Ulbright TM, ''et al.'' \|title=Best practices recommendations in the application of immunohistochemistry in urologic pathology: report from the international society of urological pathology consensus conference \|journal=Am. J. Surg. Pathol. \|volume=38 \|issue=8 \|pages=1017–22 \|year=2014 \|month=August \|pmid=25025364 \|doi=10.1097/PAS.0000000000000254 \|url=}}</ref>
	*CD117 -ve (+ve in ChRCC).		*CD117 -ve (+ve in ChRCC).
	**Aguilar-León ''et al.'' found 8% of CCRCC are CD117 +ve.<ref name=pmid25643775>{{Cite journal \| last1 = Aguilar-León \| first1 = D. \| last2 = Del Ángel-Millán \| first2 = G. \| last3 = Zepeda-Quiroz \| first3 = I. \| last4 = Soria-Céspedes \| first4 = D. \| title = [Immunohistochemical Expression of CD117 (c-kit) in 75 Renal Cell Tumors]. \| journal = Gac Med Mex \| volume = 150 Suppl 2 \| issue = \| pages = 156-60 \| month = Dec \| year = 2014 \| doi = \| PMID = 25643775 }}</ref>		**Aguilar-León ''et al.'' found ~8% of CCRCC are CD117 +ve.<ref name=pmid25643775>{{Cite journal \| last1 = Aguilar-León \| first1 = D. \| last2 = Del Ángel-Millán \| first2 = G. \| last3 = Zepeda-Quiroz \| first3 = I. \| last4 = Soria-Céspedes \| first4 = D. \| title = [Immunohistochemical Expression of CD117 (c-kit) in 75 Renal Cell Tumors]. \| journal = Gac Med Mex \| volume = 150 Suppl 2 \| issue = \| pages = 156-60 \| month = Dec \| year = 2014 \| doi = \| PMID = 25643775 }}</ref>
	**Liu ''et al.'' found ~80% of ChRCC are CD117 +ve.<ref name=pmid17683191/>		**Liu ''et al.'' found ~80% of ChRCC are CD117 +ve.<ref name=pmid17683191/>
	*CA9 ([[carbonic anhydrase 9]]) +ve (membranous).<ref name=pmid21677535>{{cite journal \|author=Al-Ahmadie HA, Alden D, Fine SW, ''et al.'' \|title=Role of immunohistochemistry in the evaluation of needle core biopsies in adult renal cortical tumors: an ex vivo study \|journal=Am. J. Surg. Pathol. \|volume=35 \|issue=7 \|pages=949–61 \|year=2011 \|month=July \|pmid=21677535 \|doi=10.1097/PAS.0b013e31821e25cd \|url=}}</ref>		*CA9 ([[carbonic anhydrase 9]]) +ve (membranous).<ref name=pmid21677535>{{cite journal \|author=Al-Ahmadie HA, Alden D, Fine SW, ''et al.'' \|title=Role of immunohistochemistry in the evaluation of needle core biopsies in adult renal cortical tumors: an ex vivo study \|journal=Am. J. Surg. Pathol. \|volume=35 \|issue=7 \|pages=949–61 \|year=2011 \|month=July \|pmid=21677535 \|doi=10.1097/PAS.0b013e31821e25cd \|url=}}</ref>