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Rogala J, Kojima F, Alaghehbandan R, Ptakova N, Bravc A, Bulimbasic S, Perez Montiel D, Slisarenko M, Ali L, Kuthi L, Pivovarcikova K, Michalova K, Bartovic B, Bartos Vesela A, Dolejsova O, Michal M, Hes O. Small cell variant of chromophobe renal cell carcinoma: Clinicopathologic, and molecular-genetic analysis of 10 cases. Bosn J Basic Med Sci 2022; 22:531-539. [PMID: 35276058 PMCID: PMC9392979 DOI: 10.17305/bjbms.2021.6935] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/31/2022] [Indexed: 11/22/2022] Open
Abstract
The morphologic diversity of chromophobe renal cell carcinoma (ChRCC) is well-known. Aside from typical morphology, pigmented adenomatoid, multicystic, and papillary patterns have been described. Ten cases of CHRCC composed of small-cell population in various percentages were analyzed, using morphologic parameters, immunohistochemistry, and next-generation sequencing testing. Patients were five males and five females, with age ranging from 40 to 78 years. The size of tumors ranged from 2.2 cm to 11 cm (mean 5.17 cm). Small-cell component comprised 10 to 80% of the tumor volume, while the remaining was formed by cells with classic ChRCC morphology. The immunohistochemical profile of the small-cell component was consistent with typical ChRCC immunophenotype, with CD117 and CK7 positivity. Neuroendocrine markers were negative. Mutations of 13 genes were found: DCIER1, FGFR3, JAK3, SUFO, FAM46C, FANCG, MET, PLCG2, APC, POLE, EPICAM, MUTYH, and AR. However, only the PLCG2 mutation is considered pathogenic. The small-cell variant of ChRCC further highlights and expands on existing morphologic heterogeneity spectrum. Recognition of small-cell variant of CHRCC is not problematic in tumors, where the “classic” CHRCC component is present. However, in limited material (i.e., core biopsy), this may present a diagnostic challenge. Based on the limited follow-up data available, it appears that the small-cell tumor component had no impact on prognosis, since there was no aggressive behavior documented. Awareness of this unusual pattern and applying additional sections to find classic morphology of ChRCC, as well as excluding neuroendocrine nature by immunohistochemistry, may help resolve difficult cases.
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Affiliation(s)
- Joanna Rogala
- Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzeň, Pilsen, Czech Republic
| | - Fumiyoshi Kojima
- Department of Human Pathology, Wakayama Medical University, Wakayama, Japan
| | - Reza Alaghehbandan
- Department of Pathology, Faculty of Medicine, University of British Columbia, Royal Columbian Hospital, Vancouver, BC, Canada
| | - Nikola Ptakova
- Department of Biology and Medical Genetics, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Czech Republic
| | - Ana Bravc
- Department of Pathology, General Hospital, Slovenj Gradec, Slovenia
| | - Stela Bulimbasic
- Department of Pathology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Delia Perez Montiel
- Department of Pathology, Institute Nacional de Cancerologia, Mexico City, Mexico
| | - Maryna Slisarenko
- Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzeň, Pilsen, Czech Republic
| | - Leila Ali
- Department of Pathology, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
| | - Levente Kuthi
- Department of Pathology, University of Szeged, Szeged, Hungary
| | - Kristyna Pivovarcikova
- Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzeň, Pilsen, Czech Republic
| | - Kvetoslava Michalova
- Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzeň, Pilsen, Czech Republic
| | - Boris Bartovic
- Departmnet of Pathology, Cytopathos, Bratislava, Slovakia
| | - Adriena Bartos Vesela
- Department of Urology, Charles University in Prague, Faculty of Medicine in Plzeň, Pilsen, Czech Republic
| | - Olga Dolejsova
- Department of Urology, Charles University in Prague, Faculty of Medicine in Plzeň, Pilsen, Czech Republic
| | - Michal Michal
- Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzeň, Pilsen, Czech Republic
| | - Ondrej Hes
- Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzeň, Pilsen, Czech Republic
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