Clear cell papillary renal cell carcinoma as part of histologically discordant multifocal renal cell carcinoma: A case report and review of literature

详细信息    查看全文

• 作者：Tiffany Shao^a ; ^{shaotiff@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Peter Yousef^b ; ^{py_basketball@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Irina Shipilova^b ; Rola Saleeb^a ; ^{rola.saleeb@mail.utoronto.ca" class="auth_mail" title="E-mail the corresponding author} ; Jason Y. Lee^b ; ^c ; ^{LeeJaso@smh.ca" class="auth_mail" title="E-mail the corresponding author} ; Adriana Krizova^a ; ^d ; ^{adriana.krizova@mail.utoronto.ca" class="auth_mail" title="E-mail the corresponding author}
• 关键词：RCC ; renal cell carcinoma ; pRCC ; papillary renal cell carcinoma ; ccRCC ; clear cell renal cell carcinoma ; ccpRCC ; clear cell papillary renal cell carcinoma ; HIF ; hypoxia inducible factors ; VHL ; Von Hippel&ndash ; Lindau
• 刊名：Pathology - Research and Practice
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：212
• 期：3
• 页码：229-233
• 全文大小：1129 K

文摘

Multifocal renal cell carcinoma of different histological subtypes within a single kidney is rare. We report a recently classified clear cell (tubulo) papillary renal cell carcinoma as part of an unusual case of multifocal renal cell carcinoma of discordant histological subtypes.

Results

A 57 year-old-man was found to have multiple renal tumors and cysts on imaging and underwent a laparoscopic left radical nephrectomy. Pathological review showed multifocal renal cell carcinoma (clear cell (tubulo) papillary, clear cell and papillary renal cell carcinomas and papillary adenomas). Morphology of clear cell papillary renal cell carcinoma was supported by immunohistochemical profile (CK7+, HMWK+, CAIX+, AMACR−, CD10−, TFE3−).

Conclusions

This is the first report of clear cell papillary renal cell carcinoma as part of multifocal renal cell carcinoma of different histological subtypes. Related lineage of clear cell renal cell carcinoma and papillary renal cell carcinoma is supported by the highest prevalence of their combination within multifocal renal cell carcinoma of different histological subtypes along with their molecular interconnection. Clear cell papillary renal cell carcinoma may be uniquely placed between clear cell and papillary renal cell carcinomas since it shows morphological features intermediate between clear cell and papillary renal cell carcinoma along with overlapping but unique immunohistochemical profile.

Clear cell papillary renal cell carcinoma may be molecularly related to clear cell and papillary renal cell carcinomas since the tumors overexpress markers of HIF pathway activation with normal/elevated VHL mRNA expression and some tumors show losses of chromosome 3. Due to the overlapping morphology, it is possible that cases of clear cell papillary renal cell carcinoma may have been misclassified as papillary or clear cell renal cell carcinoma in the literature, incorrectly increasing their reported prevalence. Identification of multifocal RCCs may be related to the extent of pathological sampling.