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Renal cell carcinoma in kidney allografts: histologic types, including biphasic papillary carcinoma.
- Source :
-
Human pathology [Hum Pathol] 2016 Nov; Vol. 57, pp. 28-36. Date of Electronic Publication: 2016 Jul 07. - Publication Year :
- 2016
-
Abstract
- Kidney transplant recipients are at increased risk for malignancy, with about 5% incidence of cancer in native end-stage kidneys. Carcinoma in the renal allograft is far less common. Prior studies have demonstrated a propensity for renal cell carcinomas (RCCs) of papillary subtypes in end-stage kidneys, and perhaps in allograft kidneys, but most allograft studies lack detailed pathologic review and predate the current classification system. We reviewed our experience with renal carcinoma in kidney allografts at 2 academic centers applying the International Society of Urological Pathology classification, informed by immunohistochemistry. The incidence of renal allograft carcinoma was about 0.26% in our population. Of 12 allograft carcinomas, 6 were papillary (50%), 4 were clear cell (33%), 1 was clear cell (tubulo)papillary, and 1 chromophobe. Two of the papillary carcinomas had distinctive biphasic glomeruloid architecture matching the newly named "biphasic squamoid alveolar" pattern and were difficult to classify on core biopsies. The 2 cell types had different immunophenotypes in our hands (eosinophilic cells: RCC-/CK34betaE12+ weight keratin +/cyclin D1+; clear cells: RCC+/cytokeratin high molecular weight negative to weak/cyclin D1-). None of the patients experienced cancer recurrences or metastasis. Our study confirms the predilection for papillary RCCs in kidney allografts and highlights the occurrence of rare morphologic variants. Larger studies are needed with careful pathologic review, which has been lacking in the literature.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Academic Medical Centers
Adult
Aged
Allografts
Biomarkers, Tumor analysis
Biopsy, Large-Core Needle
California epidemiology
Carcinoma, Renal Cell chemistry
Carcinoma, Renal Cell epidemiology
Carcinoma, Renal Cell surgery
Child
Female
Humans
Immunohistochemistry
Incidence
Kidney Neoplasms chemistry
Kidney Neoplasms epidemiology
Kidney Neoplasms surgery
Male
Middle Aged
Nephrectomy
Oregon epidemiology
Treatment Outcome
Young Adult
Carcinoma, Renal Cell pathology
Kidney Neoplasms pathology
Kidney Transplantation adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8392
- Volume :
- 57
- Database :
- MEDLINE
- Journal :
- Human pathology
- Publication Type :
- Academic Journal
- Accession number :
- 27396934
- Full Text :
- https://doi.org/10.1016/j.humpath.2016.06.018