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Eosinophilic variant of chromophobe renal cell carcinoma metastasizing to the liver: Diagnostic pitfall

Authors :
Daisuke Inoue, MD
Shoji Oura, MD, PhD
Source :
Radiology Case Reports, Vol 18, Iss 10, Pp 3504-3508 (2023)
Publication Year :
2023
Publisher :
Elsevier, 2023.

Abstract

An 82-year-old man developed a hypervascular renal tumor, 2 cm in size, and multiple liver tumors. Liver tumors had obscured tumor margins on ultrasonography. Positron emission tomography/computed tomography (PET/CT) showed no areas of avid radiotracer uptake in the liver. Routine pathological examination failed to demonstrate tumor cells in 9 tissue samples obtained from repeated core needle biopsies. Even a frozen section of the liver segment 8 tumor further failed to prove malignant cells, and an additive frozen section of the liver section 2 tumor finally proved atypical cells growing in tubular and solid fashions with eosinophilic cytoplasm. Tumors showed expansive growth patterns, were in direct contact with normal liver cells, had abundant micro-vessels, had only sparse hyalinized septa, and had no pale cells. Immunostaining revealed the tumor cells to be positive for CD10, CD117, and E-cadherin and negative for CK7, and PAX8, leading to the diagnosis of metastatic chromophobe renal cell carcinoma (chRCC) in the liver. Arginase-1 immunostaining clearly demarcated the boundary between the chRCC cells and normal hepatic cells. Diagnostic physicians should note that chRCCs are of low-grade malignancy despite their abundant intra-tumoral blood flow and can often pose imaging and pathologic diagnostic difficulties.

Details

Language :
English
ISSN :
19300433
Volume :
18
Issue :
10
Database :
Directory of Open Access Journals
Journal :
Radiology Case Reports
Publication Type :
Academic Journal
Accession number :
edsdoj.0257904d554c4fb795d4838d5289cee0
Document Type :
article
Full Text :
https://doi.org/10.1016/j.radcr.2023.07.006