Eosinophilic, solid and cystic renal cell carcinoma

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Eosinophilic, solid and cystic renal cell carcinoma
Diagnosis in short

Eosinophilic, solid and cystic renal cell carcinoma. H&E stain.

LM epithelioid cells with abundant stippled eosinophilic cytoplasm +/- peripheral clearing, round nuclei with prominent nucleoli, nested or solid architecture +/- cystic spaces with hobnail lining cells, +/-scattered histiocytes (common), +/-multi-nucleation (common), +/-small intracytoplasmic globules
LM DDx chromophobe renal cell carcinoma (eosinophilic variant), clear cell renal cell carcinoma, t(6;11) renal cell carcinoma, other renal tumours with eosinophilic cytoplasm
IHC PAX8 +ve, CK20 +ve, CK7 -ve, CA9 -ve, CD117 -ve, HMB-45 -ve
Gross solid and cystic
Site kidney - see kidney tumours

Clinical history women only
Prevalence rare
Prognosis good - data limited
Clin. DDx other kidney tumours

Eosinophilic, solid and cystic renal cell carcinoma, abbreviated ESC-RCC, is recently described, evolving kidney tumour that is presumed to be malignant.[1]

It is not within the Vancouver classification of renal tumours.[2]

General

Gross

Features:[1]

  • Tan colour.
  • Solid and usually cystic.

Microscopic

Features:[1]

  • Epithelioid cells with abundant stippled eosinophilic cytoplasm +/- peripheral clearing.
  • Round nuclei with one prominent nucleolus.
  • Nested or solid architecture +/- cystic spaces with hobnail lining cells.
  • +/-Scattered histiocytes (common).
  • +/-Multi-nucleation (common).
  • +/-Small intracytoplasmic globules - usually seen but only present in a handful of cells.

DDx:

Images

Case 1

Case 2


Micrograph of eosinophilic, solid and cystic renal cell carcinoma, abbreviated ESC-RCC. H&E stain.

ESC-RCC is an evolving type of renal cell carcinoma that has a morphology similar to one seen in tuberous sclerosis-associated renal cell carcinoma.

Case 3

IHC

Features:[1]

  • PAX8 +ve.
  • CK20 +ve.
  • CK7 -ve.
  • CD117 -ve.
  • CA9 -ve.
  • HMB-45 -ve.

See also

References

  1. 1.0 1.1 1.2 1.3 Trpkov, K.; Hes, O.; Bonert, M.; Lopez, JI.; Bonsib, SM.; Nesi, G.; Comperat, E.; Sibony, M. et al. (Sep 2015). "Eosinophilic, Solid, and Cystic Renal Cell Carcinoma: Clinicopathologic Study of 16 Unique, Sporadic Neoplasms Occurring in Women.". Am J Surg Pathol. doi:10.1097/PAS.0000000000000508. PMID 26414221.
  2. Srigley, JR.; Delahunt, B.; Eble, JN.; Egevad, L.; Epstein, JI.; Grignon, D.; Hes, O.; Moch, H. et al. (Oct 2013). "The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia.". Am J Surg Pathol 37 (10): 1469-89. doi:10.1097/PAS.0b013e318299f2d1. PMID 24025519.
  3. Guo, J.; Tretiakova, MS.; Troxell, ML.; Osunkoya, AO.; Fadare, O.; Sangoi, AR.; Shen, SS.; Lopez-Beltran, A. et al. (Nov 2014). "Tuberous Sclerosis-associated Renal Cell Carcinoma: A Clinicopathologic Study of 57 Separate Carcinomas in 18 Patients.". Am J Surg Pathol 38 (11): 1457-67. doi:10.1097/PAS.0000000000000248. PMID 25093518.