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Cytomorphology, immunoprofile, and management of renal oncocytic neoplasms
- Source :
- Cancer cytopathologyReferences. 128(12)
- Publication Year :
- 2020
-
Abstract
- Background The goal of this study was to evaluate the morphology, immunoprofile, and management of renal oncocytoma (RO), hybrid oncocytic tumor (HOT), and chromophobe renal cell carcinoma (ChRCC). Methods Forty-seven cases of RO, 7 cases of HOT, and 25 cases of ChRCC were included in the study. Tissue microarrays were prepared for immunohistochemical evaluation. Results Large sheets of cells with transverse vessels, and higher nuclear grade were seen more often in ChRCC than in RO or HOT. Tumor cells of RO were more uniform in size and shape relative to HOT and ChRCC. The cytoplasmic features of RO were more uniformly granular relative to HOT and ChRCC, which exhibited variable cytoplasmic features. CK7 and MUC1 were expressed more frequently and diffusely in ChRCC (54% and 94%, respectively) than RO (4% and 52%, respectively) and HOT (0% and 71%, respectively). AMACR and PAX8 were more frequently expressed diffusely in RO (67% and 42%, respectively) than in HOT (0% and 0%, respectively) or ChRCC (14% and 11%, respectively). Most HOT (57%) and CHRCC (60%) patients underwent nephrectomy. Cryoablation was the treatment of choice for 24% of patients with ChRCC, 2% of patients with RO, and 0% of patients with HOT. The majority of patients with RO (88%) opted for active surveillance-a much higher rate than that for patients with HOT (29%) or ChRCC (12%). Conclusion Some cytologic features and immunomarkers are useful in differentiating RO, HOT, and ChRCC. Because no immunomarker or morphologic finding is specific by itself, a combination of morphologic features with immunohistochemistry appears to be the most reliable way to distinguish ChRCC, HOT, and RO on biopsy samples. Subclassification of renal oncocytic tumors into specific categories impacts clinical management and downstream treatment selection.
- Subjects :
- Adult
Male
Cancer Research
Pathology
medicine.medical_specialty
medicine.medical_treatment
Cytodiagnosis
Chromophobe Renal Cell Carcinoma
Biopsy, Fine-Needle
030209 endocrinology & metabolism
Nephrectomy
Diagnosis, Differential
03 medical and health sciences
0302 clinical medicine
Biopsy
medicine
Biomarkers, Tumor
Adenoma, Oxyphilic
Humans
Renal oncocytoma
Carcinoma, Renal Cell
Aged
Retrospective Studies
Aged, 80 and over
Tissue microarray
medicine.diagnostic_test
business.industry
Disease Management
Histology
Middle Aged
medicine.disease
Prognosis
Immunohistochemistry
Kidney Neoplasms
Oncology
030220 oncology & carcinogenesis
Oncocytic Neoplasm
Female
PAX8
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 19346638
- Volume :
- 128
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Cancer cytopathologyReferences
- Accession number :
- edsair.doi.dedup.....bfa3c42236d8f466725118d475d14b98