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Yin Y, Tang S. A case-report of chromophobe renal cell carcinoma with renal subcapsular hematoma. Int J Surg Case Rep 2024; 118:109608. [PMID: 38581942 PMCID: PMC11004637 DOI: 10.1016/j.ijscr.2024.109608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/26/2024] [Accepted: 03/30/2024] [Indexed: 04/08/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Chromophobe renal cell carcinoma (CHRCC) is a rare subtype of renal cancer, accompanied by subcapsular renal hematoma (SRH) without a history of traumatic or hemorrhagic disease, which is clinically rare. The reason for CHRCC with SRH may be caused by tumor rupture or vascular rupture. In the early stage, it is often asymptomatic and can be easily overlooked and misdiagnosed, leading to delayed treatment and serious consequences. CASE PRESENTATION A 39-year-old female patient was admitted to the emergency department due to sudden dull pain and discomfort in the lower back. Subsequent ultrasound, CT, and MRI imaging examinations revealed the presence of chromophobe renal cell carcinoma with a volume of 4.5 × 3.5 × 3 cm in the middle and lower pole of the right kidney. In addition, a subcapsular hematoma with an area of approximately 6 × 11 cm was also found. The patient underwent laparoscopic radical nephrectomy. CLINICAL DISCUSSION Due to its atypical syptmoms and signs, it is often overlooked or misdiagnosed. CHRCC has unique histological features, which distinguish it from other subtypes of renal cell carcinoma. Imaging studies such as CT scan and MRI are helpful in diagnosing and identifying associated complications. In this case, the presence of the perirenal hematoma is a notable finding, which may be caused by tumor-induced vascular disruption. CONCLUSION This report underscores the importance of recognizing and managing complications associated with CHRCC. Early diagnosis and appropriate surgical treatment are crucial for favorable outcomes in these cases.
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Affiliation(s)
- Yuehui Yin
- Department of Radiology, Weifang People's Hospital, Weifang, Shandong, PR China
| | - Shanfang Tang
- Department of Public Health, Weifang People's Hospital, Weifang, Shandong, PR China.
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2
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Liu S, Hou M, Yao Y, Mei J, Sun L, Zhang G. External validation of a four-tiered grading system for chromophobe renal cell carcinoma. Clin Exp Med 2024; 24:61. [PMID: 38554222 PMCID: PMC10981601 DOI: 10.1007/s10238-024-01314-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 02/29/2024] [Indexed: 04/01/2024]
Abstract
This study aimed to validate the prognostic value of a four-tiered grading system recently proposed by Avulova et al. and to explore the prognostic ability of another four-tiered classification grading system in which there is a separate Grade 3 for tumor necrosis. Grading of chromophobe renal cell carcinoma (ChRCC) by the Fuhrman system is not feasible because of the inherent nuclear atypia in ChRCC. We collected relevant data of 263 patients with ChRCC who had undergone surgery in our hospital from 2008 to 2020. The Kaplan-Meier method was used to calculate the survival rate and Cox proportional hazard regression models to assess associations with cancer-specific survival and distant metastasis-free survival by hazard ratios (HRs) and 95% confidence intervals (CIs). Ten patients died from ChRCC, and 12 developed metastases. The 5 year CSS rates were 95.9%. Grades 2 (HR = 10.9; CI 1.11-106.4; P = 0.04), 3 (HR = 33.6, CI 3.32-339.1; P = 0.003), and 4 (HR = 417.4, CI 35.0-4976.2; P < 0.001) in a four-tiered grading system were significantly associated with CSS in a multivariate setting. However, the difference in CSS between Grades 2 and 3 was not significant (HR = 2.14, 95% CI 0.43-10.63; P = 0.35). The HRs of the associations between an exploratory grading system that includes a separate Grade 3 for tumor necrosis and CSS were as follows: Grade 2, 10.2 (CI 1.06-97.9, P = 0.045); Grade 3, 11.4 (CI 1.18-109.6, P = 0.04); and Grade 4, 267.9 (CI 27.6-2603.3, P < 0.001). Similarly, Grades 2 and 3 did not differ significantly. The four-tiered grading system studied is useful for predicting death from ChRCC and metastasis. However, Grade 3 did not more accurately predict risk of death and metastasis than did Grade 2. This was also true for the novel exploratory grading system that classifies tumors with necrosis into a separate Grade 3.
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Affiliation(s)
- Shuai Liu
- Department of Urology, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Rd, Qingdao, 266003, China
| | - Mingyu Hou
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yu Yao
- Department of Urology, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Rd, Qingdao, 266003, China
| | - Jingchang Mei
- Department of Urology, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Rd, Qingdao, 266003, China
| | - Lijiang Sun
- Department of Urology, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Rd, Qingdao, 266003, China
| | - Guiming Zhang
- Department of Urology, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Rd, Qingdao, 266003, China.
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Xu Y, Hua J, Que H, Zeng T, Li Q, Deng J, Xie J. Identification of PANoptosis-related signature reveals immune infiltration characteristics and immunotherapy responses for renal cell carcinoma. BMC Cancer 2024; 24:292. [PMID: 38439022 PMCID: PMC10913266 DOI: 10.1186/s12885-024-12067-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/27/2024] [Indexed: 03/06/2024] Open
Abstract
PANoptosis is a specific type of inflammatory programmed cell death (PCD) modality that can be involved in three key modes of cellular programmed cell death-pyroptosis, apoptosis and necroptosis. We analyzed PANoptosis activity in three common renal cell carcinoma subtypes (Clear cell renal cell carcinoma, Papillary renal cell carcinoma, and Chromophobe renal cell carcinoma) separately and constructed a new PANoptosis immunity index (PANII). In three renal cell carcinomas, we found that PANII was an effective predictor of immunotherapy efficacy in KIRC, KIRP and KICH, and the high PANII group was characterized by high immune infiltration and sensitivity to immunotherapy, while the low PANII group was prone to immune escape and immunotherapy resistance. We performed molecular docking prediction of each core protein comprising PANII and identified natural small molecule compounds with the highest affinity to target proteins. In addition, we found that down-regulation of PYCARD inhibited the proliferation and migration of renal clear cell carcinoma cells by in vitro functional assays, suggesting that PYCARD could be a novel target for renal clear cell carcinoma therapy. Our findings that the PANoptosis characterization-based index (PANII) helps to elucidate the tumor microenvironmental features of three common renal cell carcinoma subtypes and identify patient populations that will benefit from immunotherapy, providing a new tool for the clinical diagnosis and treatment of patients with intermediate- and advanced-stage renal cell carcinoma.
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Affiliation(s)
- Yan Xu
- Department of Urology, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Jingqi Hua
- Department of Urology, Suzhou Municipal Hospital, Suzhou, 215001, China
| | - Hongliang Que
- Department of Urology, Suzhou Municipal Hospital, Suzhou, 215001, China
| | - Tengyue Zeng
- Department of Urology, Suzhou Municipal Hospital, Suzhou, 215001, China
| | - Quan Li
- Department of Urology, Suzhou Municipal Hospital, Suzhou, 215001, China
| | - Junpeng Deng
- Department of Urology, Suzhou Municipal Hospital, Suzhou, 215001, China.
| | - Jianjun Xie
- Department of Urology, Suzhou Municipal Hospital, Suzhou, 215001, China.
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Yang S, Jian Y, Yang F, Liu R, Zhang W, Wang J, Tan X, Wu J, Chen Y, Zhou X. Radiomics analysis based on single phase and different phase combinations of radiomics features from tri-phasic CT to distinguish renal oncocytoma from chromophobe renal cell carcinoma. Abdom Radiol (NY) 2024; 49:182-191. [PMID: 37907684 DOI: 10.1007/s00261-023-04053-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVES To investigate different radiomics models based on single phase and the different phase combinations of radiomics features from 3D tri-phasic CT to distinguish RO from chRCC. METHODS A total of 96 patients (30 RO and 66 chRCC) were enrolled in this study. Radiomics features were extracted from unenhanced phase (UP), corticomedullary phase (CMP), and nephrographic phase (NP) CT images. Feature selection was based on the least absolute shrinkage and selection operator regression (LASSO) method. The selected features were used to develop different radiomics models using logistic regression (LR) analysis, including model 1 (UP), model 2(CMP), model 3(NP), model 4(UP+CMP), model 5(UP+NP), model 6(CMP+NP), and model 7(UP+CMP+NP). The radiomics model demonstrating the highest discrimination performance was utilized to construct the combined model (model 8) with clinical factors. A nomogram based on the model 8 was established. To evaluate the diagnostic performance of the different models, the receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used. Delong's test was utilized to assess the statistical significance of the AUC improvement across the models. RESULTS Among the seven radiomics models, model 7 exhibited the highest AUC of 0.84 (95% CI 0.69, 0.99), and model 7 demonstrated a significantly superior AUC compared to the other radiomics models (all P < 0.05). The AUC values of radiomics models based on two phases (model4, mode5, mode6) were greater than the models based on single phase (model1, mode2, mode3) (all P < 0.05). Model 3 illustrated the best performance of the three radiomics models based on single phase with an AUC of 0.76 (95% CI 0.57, 099). Model 6 illustrated the best performance of the three radiomics models based on two-phases combination with an AUC of 0.83 (0.66, 0.99). Model 8 achieved an AUC of 0.93 (95% CI 0.83, 1.00) which is higher than those all radiomics models. CONCLUSION Radiomics models based on combination of radiomics features from UP, CMP, and NP can be a useful and promising technique to differentiate RO from chRCC. Moreover, the model combining clinical factors and radiomics features showed better classification performance to distinguish them.
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Affiliation(s)
- Suping Yang
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yuanxi Jian
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
| | - Fan Yang
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Rui Liu
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wenqing Zhang
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jiaping Wang
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xin Tan
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Junlin Wu
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yuan Chen
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiaowen Zhou
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
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Liu S, Yao Y, Hou M, Mei J, Sun L, Zhang G. Identification and validation of a ferroptosis-related signature for prediction of the prognosis and tumor microenvironment in patients with chromophobe renal cell carcinoma. BMC Cancer 2023; 23:1079. [PMID: 37940859 PMCID: PMC10634106 DOI: 10.1186/s12885-023-11589-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Ferroptosis is a novel form of regulated cell death that is different from other forms, which has an important role in tumor growth inhibition. The purpose of this study was to construct and validate a prognostic signature related to ferroptosis in chromophobe renal cell carcinoma (ChRCC) and to explore its role in immune cell infiltration and systemic therapy. METHODS The gene expression profiles of ChRCC patients obtained from The Cancer Genome Atlas (TCGA) database were used to identify differentially expressed prognostic ferroptosis-related genes (FRGs) by univariate Cox proportional hazards analyses. Ferroptosis molecular subtypes were obtained by consensus clustering analysis. The FRG-based signature in the training set was established by least absolute shrinkage and selection operator analysis and verified in the testing set. The association between molecular subtypes and the prognostic signature and immune microenvironment was explored to predict responses to immunotherapy. Immunohistochemistry was used to verify expression of the FRG-based signature externally. RESULTS ChRCC patients were divided into two FRG subtypes. Two FRGs (TFRC and SLC7A11) were identified to construct the prognostic signature. The high-risk group and cluster 2 had worse overall survival than the low-risk group and cluster 1, respectively. The low-risk group and cluster 1 had higher levels of immune cell infiltration and expression of MHC and immune checkpoint molecules than the high-risk group and cluster 2. The risk score was a predictor of overall survival and had a good predictive ability, which was verified in the testing set and evaluated by ROC and calibration curves. The high-risk group had a higher tumor mutation burden. The different sensitivities of targeted drugs in patients with different risks were evaluated. External immunohistochemical analysis showed that TFRC and SLC7A11 were highly expressed in tumor tissues compared with para-cancer normal tissues, and the expression level was significantly associated with a more advanced stage and worse cancer-specific survival. CONCLUSIONS An FRG signature was identified and validated to predict the clinicopathological features and prognosis of ChRCC. A significant association between the signature and immune cell infiltration, immune checkpoint expression, and drug response is helpful to guide comprehensive treatment of ChRCC.
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Affiliation(s)
- Shuai Liu
- Department of Urology, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Rd, 266003, Qingdao, P.R. China
| | - Yu Yao
- Department of Urology, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Rd, 266003, Qingdao, P.R. China
| | - Mingyu Hou
- Department of Pathology, The Affiliated Hospital of Qingdao University, 266003, Qingdao, P.R. China
| | - Jingchang Mei
- Department of Urology, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Rd, 266003, Qingdao, P.R. China
| | - Lijiang Sun
- Department of Urology, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Rd, 266003, Qingdao, P.R. China
| | - Guiming Zhang
- Department of Urology, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Rd, 266003, Qingdao, P.R. China.
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Wu HF, Liu H, Zhang ZW, Chen JM. CENPE and LDHA were potential prognostic biomarkers of chromophobe renal cell carcinoma. Eur J Med Res 2023; 28:481. [PMID: 37925501 PMCID: PMC10625266 DOI: 10.1186/s40001-023-01449-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 10/15/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Most sarcomatoid differentiated renal cell carcinoma was differentiated from Chromophobe renal cell carcinoma (KICH) and related to a bad prognosis. Thus, finding biomarkers is important for the therapy of KICH. METHODS The UCSC was used for determining the expression of mRNA and miRNA and clinical data in KICH and normal samples. KEGG and GO were used for predicting potential function of differently expressed genes (DEGs). Optimal prognostic markers were determined by Lasso regression. Kaplan-Meier survival, ROC, and cox regression were used for assessing prognosis value. GSEA was used for predicting potential function of markers. The relations between markers and immune cell infiltration were determined by Pearson method. The upstream miRNA of markers was predicted in TargetScan and DIANA. RESULTS The 6162 upregulated and 13,903 downregulated DEGs were identified in KICH. Further CENPE and LDHA were screened out as optimal prognostic risk signatures. CENPE was highly expressed while LDHA was lowly expressed in KICH samples, and the high expressions of 2 genes contributed to bad prognosis. The functions of CENPE and LDHA were mainly enriched in proliferation related pathways such as cell cycle and DNA replication. In addition, the correlation of 2 genes with immune infiltrates in KICH was also observed. Finally, we found that has-miR-577 was the common upstream of 2 genes and the binding sites can be predicted. CONCLUSION CENPE and LDHA were identified as the important prognostic biomarkers in KICH, and they might be involved in the proliferation of cancer cell.
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Affiliation(s)
- Hui-Feng Wu
- Department of Urology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou, 310009, Zhejiang, China
| | - Hao Liu
- Department of Urology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou, 310009, Zhejiang, China.
| | - Zhe-Wei Zhang
- Department of Urology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou, 310009, Zhejiang, China
| | - Ji-Min Chen
- Department of Urology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou, 310009, Zhejiang, China
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Abstract
The term variant histology renal cell carcinomas (vhRCCs), also known as non-clear cell RCCs, refers to a diverse group of malignancies with distinct biologic and therapeutic considerations. The management of vhRCC subtypes is often based on extrapolating results from the more common clear cell RCC studies or basket trials that are not specific to each histology. The unique management of each vhRCC subtype necessitates accurate pathologic diagnosis and dedicated research efforts. Herein, we discuss tailored recommendations for each vhRCC histology informed by ongoing research and clinical experience.
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Affiliation(s)
- Pavlos Msaouel
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; Department of Translational Molecular Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA; David H. Koch Center for Applied Research of Genitourinary Cancers, The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Giannicola Genovese
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; David H. Koch Center for Applied Research of Genitourinary Cancers, The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA; Department of Genomic Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA; TRACTION Platform, Division of Therapeutic Discoveries, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
| | - Nizar M Tannir
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Inoue D, Oura S. Eosinophilic variant of chromophobe renal cell carcinoma metastasizing to the liver: Diagnostic pitfall. Radiol Case Rep 2023; 18:3504-3508. [PMID: 37560153 PMCID: PMC10407264 DOI: 10.1016/j.radcr.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 08/11/2023] Open
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.
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Affiliation(s)
- Daisuke Inoue
- Department of Surgery, Kishiwada Tokushukai Hospital, Kishiwada-city, Osaka, 596-8522 Japan
| | - Shoji Oura
- Department of Surgery, Kishiwada Tokushukai Hospital, Kishiwada-city, Osaka, 596-8522 Japan
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Aydoğan C, Cansu A, Aydoğan Z, Erdemi S, Teymur A, Bektaş O, Mungan S, Kazaz İO. Diagnostic performance of multiparametric magnetic resonance imaging in the differentiation of clear cell renal cell cancer. Abdom Radiol (NY) 2023; 48:2349-2360. [PMID: 37071122 DOI: 10.1007/s00261-023-03882-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE This study aimed to evaluate the diagnostic performance of multiparametric magnetic resonance imaging (mpMRI) in the differentiation of renal cell carcinoma (RCC) subtypes. METHODS This is a retrospective diagnostic performance study, in which the diagnostic performances of mpMRI features were evaluated to differentiate clear cell RCC (ccRCC) from non-clear cell RCC (non-ccRCC). Adult patients who were evaluated using a 3-Tesla dynamic contrast-enhanced mpMRI before undergoing partial or radical nephrectomy for possible malignant renal tumors were included in the study. Signal intensity change percentages (SICP) between contrast-enhanced phases and pre-administration period for both the tumor and normal renal cortex, and tumor-to-cortex enhancement index (TCEI); tumor apparent diffusion coefficient (ADC) values; tumor-to-cortex ADC ratio; and a scale which was developed according to the tumor signal intensities on the axial fat-suppressed T2-weighted Half-Fourier Acquisition Single-shot Turbo spin Echo (HASTE) images were used in ROC analysis to estimate the presence of ccRCC in the patients. The reference test positivity was the histopathologic examination of the surgical specimens. RESULTS Ninety-eight tumors from 91 patients were included in the study, and 59 of them were ccRCC, 29 were pRCC, and 10 were chRCC. The mpMRI features that had the three highest sensitivity rates were excretory phase SICP, T2-weighted HASTE scale score, and corticomedullary phase TCEI (93.2%, 91.5%, and 86.4%, respectively). However, those with the three highest specificity rates were nephrographic phase TCEI, excretory phase TCEI, and tumor ADC value (94.9%, 94.9%, and 89.7%, respectively). CONCLUSION Several parameters on mpMRI showed an acceptable performance to differentiate ccRCC from non-ccRCC.
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Affiliation(s)
- Cemal Aydoğan
- Department of Radiology, Trabzon Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Turkey.
| | - Ayşegül Cansu
- Department of Radiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Zeynep Aydoğan
- Department of Radiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Sinan Erdemi
- Department of Radiology, Tokat State Hospital, Tokat, Turkey
| | - Aykut Teymur
- Department of Radiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Onur Bektaş
- Department of Radiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Sevdegül Mungan
- Department of Pathology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - İlke Onur Kazaz
- Department of Urology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
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Botelho AR, Silva HF, Martins IS, Carneiro IC, Carvalho SD, Henrique RM, Tuchin VV, Oliveira LM. Fast calculation of spectral optical properties and pigment content detection in human normal and pathological kidney. Spectrochim Acta A Mol Biomol Spectrosc 2023; 286:122002. [PMID: 36274538 DOI: 10.1016/j.saa.2022.122002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
A fast calculation method was used to obtain the spectral optical properties of human normal and pathological (chromophobe renal cell carcinoma) kidney tissues. Using total transmittance, total reflectance and collimated transmittance spectra acquired from ex vivo kidney samples, the spectral optical properties of both tissues, namely the absorption, the scattering and the reduced scattering coefficients, as well as the scattering anisotropy, dispersion and light penetration depth, were calculated between 200 and 1000 nm. Analysis of the mean absorption coefficient spectra of the kidney tissues showed that both contain melanin and lipofuscin, and that 83 % of the melanin in the normal kidney converts into lipofuscin in the pathological kidney.
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Affiliation(s)
- Ana R Botelho
- Physics Department, Polytechnic of Porto - School of Engineering (ISEP), Porto, Portugal
| | - Hugo F Silva
- Porto University, School of Engineering, Porto, Portugal
| | - Inês S Martins
- Center for Innovation in Engineering and Industrial Technology, ISEP, Porto, Portugal
| | - Isa C Carneiro
- Department of Pathology and Cancer Biology and Epigenetics Group, Portuguese Oncology Institute of Porto, Porto, Portugal; Department of Pathological, Cytological and Thanatological Anatomy, Polytechnic of Porto - School of Health (ESS), Porto, Portugal
| | - Sónia D Carvalho
- Department of Pathology and Cancer Biology and Epigenetics Group, Portuguese Oncology Institute of Porto, Porto, Portugal; Department of Pathology, Santa Luzia Hospital (ULSAM), Viana do Castelo, Portugal
| | - Rui M Henrique
- Department of Pathology and Cancer Biology and Epigenetics Group, Portuguese Oncology Institute of Porto, Porto, Portugal; Department of Pathology and Molecular Immunology, Porto University - Institute of Biomedical Sciences Abel Salazar, Porto, Portugal
| | - Valery V Tuchin
- Science Medical Center, Saratov State University, Saratov, Russian Federation; Laboratory of Laser Molecular Imaging and Machine Learning, Tomsk State University, Tomsk, Russian Federation; Laboratory of Laser Diagnostics of Technical and Living Systems, Institute of Precision Mechanics and Control, FRC "Saratov Research Centre of Russian Academy of Sciences," Saratov, Russian Federation
| | - Luís M Oliveira
- Physics Department, Polytechnic of Porto - School of Engineering (ISEP), Porto, Portugal; Institute for Systems and Computer Engineering, Technology and Science (INESC TEC), Porto, Portugal.
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Akgul M, Williamson SR. How New Developments Impact Diagnosis in Existing Renal Neoplasms. Surg Pathol Clin 2022; 15:695-711. [PMID: 36344184 DOI: 10.1016/j.path.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
In recent years, several emerging diagnostic entities have been described in renal cell carcinoma (RCC). However, our understanding of well-known and established entities has also grown. Clear cell papillary RCC is now relabeled as a tumor rather than carcinoma in view of its nonaggressive behavior. Renal tumors with a predominantly infiltrative pattern are very important for recognition, as most of these have aggressive behavior, including fumarate hydratase-deficient RCC, SMARCB1-deficient medullary carcinoma, collecting duct carcinoma, urothelial carcinoma, and metastases from other cancers.
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Affiliation(s)
- Mahmut Akgul
- Department of Pathology and Laboratory Medicine, Albany Medical Center, 47 New Scotland Ave, Room F110S, MC81 Albany, NY 12208, USA
| | - Sean R Williamson
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Mail Code L25 Cleveland, OH 44195, USA.
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12
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Manini C, Imaz I, de Larrinoa AF, López JI. Algorithm-Based Approach to the Histological Routine Diagnosis of Renal Oncocytic Tumors in Core Biopsy Specimens. Curr Urol Rep 2022; 23:327-333. [PMID: 36169870 DOI: 10.1007/s11934-022-01114-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW A growing number of tumor entities with badly defined limits are enlarging in the last years the family of oncocytic tumors in the kidney. RECENT FINDINGS Chromophobe renal cell carcinoma (ChRCC) and renal oncocytoma (RO) are classically well-known tumors, but the borderland between them, and their precise connection, remains a matter of debate. Aside from that, other emerging and provisional entities, like eosinophilic solid and cystic renal cell carcinoma (ESC RCC), eosinophilic vacuolated tumor (EVT), low-grade oncocytic tumor (LOT), and papillary renal neoplasm with reverse polarity (PRRP), have been recently described. This spectrum of tumors remains a diagnostic challenge in renal pathology, especially if the specimen obtained is scarce. This review focuses on practical diagnostic problems when managing core biopsies and proposes a diagnostic algorithm maximizing the information provided by both morphology and immunohistochemistry. So, a combination of morphologic features on hematoxylin-eosin and six antibodies (CK7, CD117, CK20, CD10, GATA-3, and cathepsin K) is advised to be used in a stepwise fashion.
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Affiliation(s)
- Claudia Manini
- Department of Pathology, San Giovanni Bosco Hospital, 10154, Turin, Italy.,Department of Sciences of Public Health and Pediatrics, University of Turin, 10124, Turin, Italy
| | - Igone Imaz
- Department of Pathology, Cruces University Hospital, 48903, Barakaldo, Spain
| | | | - José I López
- Biomarkers in Cancer Unit, Biocruces-Bizkaia Health Research Institute, Plaza de Cruces s/n, 48903, Barakaldo, Bizkaia, Spain.
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13
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Li J, Liu F, Liu X, Hu Y, Liu Z, Shen Y, Wan J. Heterozygous germline FLCN mutation in Birt-Hogg-Dubé syndrome with bilateral renal hybrid oncocytic/chromophobe tumor and unilateral renal chromophobe cell carcinoma: a case report. J Cancer Res Clin Oncol 2022; 149:2319-2325. [PMID: 36258004 DOI: 10.1007/s00432-022-04417-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 10/11/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Birt-Hogg-Dubé (BHD) syndrome is a rare autosomal dominant tumor syndrome caused by Folliculin (FLCN) gene mutation. The clinical manifestations are diverse, and the renal tumor is the most serious. CASE PRESENTATION We report the case of a 51-year-old female with multiple space-occupying lesions in both kidneys, as well as bilateral renal cysts and multiple lung cysts. The resected tumors were finally diagnosed as bilateral renal hybrid oncocytic/chromophobe tumor (HOCT) and unilateral chromophobe cell carcinoma. A history of pneumothorax surgery 4 years ago was convinced. All of these strongly suggested the possibility of BHD syndrome. Gene test confirmed a heterozygous germline FLCN nonsense mutation (c.1429C > T, p.Arg477Ter). The patient is still doing well after 20 months of follow-up (cut-off date July 2022). CONCLUSION This is a case of BHD syndrome presented with bilateral renal tumor, renal cysts, and multiple lung cysts, and confirmed by gene testing. Patients with any combination of one or more of the manifestations should remain alert to the BHD syndrome. Our report will help to deepen the understanding of the clinicopathological features and molecular changes of BHD syndrome.
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Affiliation(s)
- Jun Li
- Institute of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Fan Liu
- Institute of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.,Department of Pathology, The Eighth Hospital of Wuhan, Wuhan, 430010, China
| | - Xuguang Liu
- Institute of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yu Hu
- Institute of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zheng Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yaqi Shen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jie Wan
- Institute of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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14
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Erlmeier F, Sun N, Shen J, Feuchtinger A, Buck A, Prade VM, Kunzke T, Schraml P, Moch H, Autenrieth M, Weichert W, Hartmann A, Walch A. Matrix-Assisted Laser Desorption/Ionization Mass Spectrometry Imaging: Diagnostic Pathways and Metabolites for Renal Tumor Entities. Oncology 2022; 101:126-133. [PMID: 36198279 DOI: 10.1159/000526436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/20/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Correct tumor subtyping of primary renal tumors is essential for treatment decision in daily routine. Most of the tumors can be classified based on morphology alone. Nevertheless, some diagnoses are difficult, and further investigations are needed for correct tumor subtyping. Besides histochemical investigations, high-mass-resolution matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI) can detect new diagnostic biomarkers and hence improve the diagnostic. PATIENTS AND METHODS Formalin-fixed paraffin embedded tissue specimens from clear cell renal cell carcinoma (ccRCC, n = 552), papillary renal cell carcinoma (pRCC, n = 122), chromophobe renal cell carcinoma (chRCC, n = 108), and renal oncocytoma (rO, n = 71) were analyzed by high-mass-resolution MALDI fourier-transform ion cyclotron resonance (FT-ICR) MSI. The SPACiAL pipeline was executed for automated co-registration of histological and molecular features. Pathway enrichment and pathway topology analysis were performed to determine significant differences between RCC subtypes. RESULTS We discriminated the four histological subtypes (ccRCC, pRCC, chRCC, and rO) and established the subtype-specific pathways and metabolic profiles. rO showed an enrichment of pentose phosphate, taurine and hypotaurine, glycerophospholipid, amino sugar and nucleotide sugar, fructose and mannose, glycine, serine, and threonine pathways. ChRCC is defined by enriched pathways including the amino sugar and nucleotide sugar, fructose and mannose, glycerophospholipid, taurine and hypotaurine, glycine, serine, and threonine pathways. Pyrimidine, amino sugar and nucleotide sugar, glycerophospholipids, and glutathione pathways are enriched in ccRCC. Furthermore, we detected enriched phosphatidylinositol and glycerophospholipid pathways in pRCC. CONCLUSION In summary, we performed a classification system with a mean accuracy in tumor discrimination of 85.13%. Furthermore, we detected tumor-specific biomarkers for the four most common primary renal tumors by MALDI-MSI. This method is a useful tool in differential diagnosis and biomarker detection.
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Affiliation(s)
- Franziska Erlmeier
- Institute of Pathology, University Hospital Erlangen-Nuernberg, Erlangen, Germany
| | - Na Sun
- Research Unit Analytical Pathology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Jian Shen
- Research Unit Analytical Pathology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Annette Feuchtinger
- Research Unit Analytical Pathology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Achim Buck
- Research Unit Analytical Pathology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Verena M Prade
- Research Unit Analytical Pathology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Thomas Kunzke
- Research Unit Analytical Pathology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Peter Schraml
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Holger Moch
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Michael Autenrieth
- Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany
| | - Wilko Weichert
- Institute of Pathology, Technical University Munich, Munich, Germany
| | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen-Nuernberg, Erlangen, Germany
| | - Axel Walch
- Research Unit Analytical Pathology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
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15
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El Kebir A, Niyonkuru E, Alafifi M, Guebessi NB, Karkouri M, Aboutaieb R. Chromophobe renal cell carcinoma with liposarcomatous dedifferentiation: a case report. Pan Afr Med J 2022; 42:206. [PMID: 36284572 PMCID: PMC9547027 DOI: 10.11604/pamj.2022.42.206.34595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/16/2022] [Indexed: 11/11/2022] Open
Abstract
Chromophobe renal cell carcinoma with liposarcomatous dedifferentiation is a very extremely rare tumor and only few cases have been reported in the literature. Here we report a case of a 37-year-old woman who presented with a pain and a palpable mass in the right flank. The abdominal computed tomography (CT) scan found a renal tumor and the patient underwent a right radical nephrectomy with adrenal gland resection. After the histological examination of the specimen completed by immunohistochemical and molecular study, a diagnosis of chromophobe renal cell carcinoma with liposarcomatous dedifferentiation was made. The patient received adjuvant chemotherapy. Afterwards, she developed bone metastasis and died 13 months after the surgery. Chromophobe renal cell carcinoma with liposarcomatous dedifferentiation is a rare tumor associated with a poor prognosis and a metastatic potential.
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Affiliation(s)
- Asmaa El Kebir
- Department of Pathology, Ibn Rochd University Hospital Center, Casablanca, Morocco,,Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
| | - Evrard Niyonkuru
- Department of Pathology, Ibn Rochd University Hospital Center, Casablanca, Morocco,,Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco,,Corresponding author: Evrard Niyonkuru, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Department of Pathology, Ibn Rochd University Hospital Center, Casablanca, Morocco.
| | - Mahmoud Alafifi
- Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco,,Department of Urology, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Nisrine Bennani Guebessi
- Department of Pathology, Ibn Rochd University Hospital Center, Casablanca, Morocco,,Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
| | - Mehdi Karkouri
- Department of Pathology, Ibn Rochd University Hospital Center, Casablanca, Morocco,,Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
| | - Rachid Aboutaieb
- Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco,,Department of Urology, Ibn Rochd University Hospital Center, Casablanca, Morocco
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16
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Kwon HJ, Jang MH. Chromophobe renal cell carcinoma-like thyroid carcinoma: possible misdiagnosis as metastatic renal cell carcinoma. Int J Clin Exp Pathol 2021; 14:1095-1101. [PMID: 34900078 PMCID: PMC8661068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/15/2021] [Indexed: 06/14/2023]
Abstract
To date, multiple thyroid cancer variants have been reported. Herein, we report a rare case of chromophobe renal cell carcinoma-like thyroid carcinoma (CRETHCA) in a 60-year-old woman, for which the morphologic findings resembled those of chromophobe renal cell carcinoma (ChRCC). ChRCC of the kidney is characterized by large polygonal tumor cells with distinct cell borders, perinuclear clearing, multiple binucleate cells, and strongly positive immunostaining for paired box gene 8 (PAX8) and carbonic anhydrase IX (CA IX). In our case, the thyroid gland tumor was incidentally detected by routine medical screening without sufficient medical information; it showed similar histology and immunohistochemical features to ChRCC and was initially misdiagnosed as metastatic ChRCC. Additional tests, including kidney computed tomography and positron emission tomography, revealed no abnormalities in the patient's kidney; therefore, we diagnosed the tumor as CRETHCA. Focal weak staining for thyroid transcription factor 1 (TTF-1) was the only supporting evidence that it was a primary thyroid neoplasm. To the best of our knowledge, this is the second report of CRETHCA in literature. This novel variant is very difficult to distinguish from metastatic ChRCC and can be a diagnostic challenge for pathologists. Further studies of similar cases should be done to define this new entity.
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Affiliation(s)
- Hee Jung Kwon
- Department of Pathology, Yeungnam University College of Medicine Daegu, South Korea
| | - Min Hye Jang
- Department of Pathology, Yeungnam University College of Medicine Daegu, South Korea
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17
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Polifka I, Ohashi R, Moch H. [Oncocytic tumours of the kidney-new differential diagnoses]. Pathologe 2021; 42:551-9. [PMID: 34468818 DOI: 10.1007/s00292-021-00979-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/14/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Recent developments in differential diagnosis have led to new knowledge about oncocytic renal neoplasms. OBJECTIVES Overview of differential diagnosis of oncocytic tumours. MATERIALS AND METHODS We performed a literature search on oncocytic renal tumours and mapped known tumour types. Possible differential diagnoses are discussed. RESULTS Besides the tumour types already acknowledged by the 2016 WHO classification, there is new evidence regarding the group of hard-to-classify oncocytic neoplasms. Findings point to immunohistochemical and molecular characteristics that may lead to the establishment of new entities in the future. In addition, important differential diagnosis can now be identified, facilitating specific therapies for oncocytic renal tumours. CONCLUSION A correct diagnosis of oncocytic renal tumours not only improves prognostic assessment (and, if necessary, specific therapies) but is also clinically relevant regarding a possible association with hereditary tumour syndromes.
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18
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Ballati A, Essaidi Z, El Jai SR, Hajri A, Errguibi D, Boufettal R, Chehab F. Chromophobe renal cell carcinoma: A case report and literature review. Ann Med Surg (Lond) 2021; 68:102643. [PMID: 34401129 PMCID: PMC8350170 DOI: 10.1016/j.amsu.2021.102643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/27/2021] [Accepted: 07/27/2021] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Chromophobe renal cell carcinoma, a distinct subtype of renal cell carcinoma (RCC) with characteristic light microscopic, histochemical, and ultrastructural features, typically has a favorable clinical course. PRESENTATION OF CASE A 45-year-old femele presented with abdominal pain. A physical examination found a palpable mass in the left upper quadrant of the abdomen. A CT scan of the abdomen showed a heterogeneously enhancing mass, with necrosis and calcifications contents betwen the liver and the right kidney. she underwent surgical resection. Partial nephrectomy was performed. Pathological diagnosis was Chromophobe renal cell carcinoma. DISCUSSION AND CONCLUSION Chromophobe RCC is a rare variety of kidney neoplasm that has recently been better characterized from a molecular and genetic perspective. Overall, it is considered to have a better prognosis, and is associated with earlier stage tumors and longer overall survival compared with clear cell RCC.
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Affiliation(s)
- Ahmed Ballati
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Faculty of Medecine and Pharmacy, Hassan II University, 9,Gascogne Street, Casablanca, Morocco
| | - Zakaria Essaidi
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Faculty of Medecine and Pharmacy, Hassan II University, 9,Gascogne Street, Casablanca, Morocco
| | - Saad Rifki El Jai
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Faculty of Medecine and Pharmacy, Hassan II University, 9,Gascogne Street, Casablanca, Morocco
| | - Amal Hajri
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Faculty of Medecine and Pharmacy, Hassan II University, 9,Gascogne Street, Casablanca, Morocco
| | - Driss Errguibi
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Faculty of Medecine and Pharmacy, Hassan II University, 9,Gascogne Street, Casablanca, Morocco
| | - Rachid Boufettal
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Faculty of Medecine and Pharmacy, Hassan II University, 9,Gascogne Street, Casablanca, Morocco
| | - Farid Chehab
- Departement of General Surgery, University Hospital Centre Ibn Rochd, Faculty of Medecine and Pharmacy, Hassan II University, 9,Gascogne Street, Casablanca, Morocco
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19
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Pieretti AC, Westerman ME, Childs A, Millward N, Shapiro DD, Sircar K, Rao P, Jonasch E, Campbell MT, Tannir NM, Matin SF, Wood CG, Karam JA. Sarcomatoid features and lymph node-positive disease in chromophobe renal cell carcinoma. Urol Oncol 2021:S1078-1439(21)00275-1. [PMID: 34301458 DOI: 10.1016/j.urolonc.2021.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/22/2021] [Accepted: 06/21/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE The presence of sarcomatoid features and/or lymph node-positive disease may be associated with a worse prognosis in chromophobe renal cell carcinoma (ChRCC). We sought to better characterize patients' long-term outcomes with these features compared with those without these features. MATERIALS AND METHODS We identified 300 patients treated for sporadic, unilateral, nonmetastatic ChRCC between 1993 and 2019. Clinical and pathologic features were summarized, and cancer-specific survival (CSS) and recurrence-free survival (RFS) were analyzed using Kaplan-Meier plots. Cox regression analysis was performed to determine factors associated with recurrence. Patients with sarcomatoid features and/or nodal disease were grouped as high-risk in a secondary analysis. RESULTS The median age was 60 years, 43.7% were female, 29.3% had pT3/T4 disease, 3.3% had sarcomatoid features, and 4% had pathologic N1 disease. Sixteen patients were categorized as high-risk based on the presence of sarcomatoid features (n = 4), pathologic N1 disease (n = 6), or both (n = 6). There were 22 recurrences; the recurrence rate in the low-risk group was 4.9% and 50% in the high-risk group. 10-year RFS was 91.4% in the low-risk group and 34.4% in the high-risk group (P < 0.001). 10-year CSS was 96.4% in the low-risk group and 54.3% in the high-risk group (P < 0.001). In multivariable analysis, sarcomatoid features (HR 5.5, CI 1.5-20.2, P = 0.01) and pN1 disease (HR 16.5, CI 5.3-51.4, P < 0.0001) were independently associated with RFS. CONCLUSIONS The presence of sarcomatoid features and/or lymph node-positive disease portends a poor prognosis in ChRCC. Further studies evaluating the impact of novel therapeutic agents in these patients are warranted.
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20
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Guo K, Ren S, Cao Y, Zhang H, Zhang Y, Gu X, Wang Z. Differentiation between renal oncocytomas and chromophobe renal cell carcinomas using dynamic contrast-enhanced computed tomography. Abdom Radiol (NY) 2021; 46:3309-16. [PMID: 33710383 DOI: 10.1007/s00261-021-03018-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/20/2021] [Accepted: 02/25/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate the ability of inferior vena cava-lesion-attenuation-difference (ILAD) and lesion-cortex-attenuation-ratio (LCAR) to differentiate renal oncocytomas (RO) from chromophobe renal cell carcinomas (chRCC). METHODS Retrospective study with analysis of 84 cases of chRCC and 30 cases of RO confirmed by surgical pathology. ILAD was calculated by measuring the difference in Hounsfield units (HU) between the inferior vena cava and the lesion of interest on the same image slice on preoperative CT scan. Calculating LCAR using the CT attenuation ratio of lesion to renal cortex at the same image slice. Receiver operating characteristic (ROC) curves were plotted to analyze the diagnostic values of ILAD and LCAR for disease activity. RESULTS There were no statistically significant differences in demographic and lesion characteristics between patients with chRCC and RO (p > 0.05). ILAD has significant statistical differences in the identification of RO and chRCC in the arterial (p = 0.031), venous (p = 0.047), and delayed phase (p = 0.002). And LCAR showed a statistically significant difference between two lesions during the arterial (p = 0.043), venous (p = 0.026), and delayed phase (p = 0.008). When all significant variables were used in combination to build a predicting model (Mix), the AUC was 0.871 (95% CI 0.759-0.984) with 67.9% sensitivity and 100% specificity. CONCLUSION ILAD and LCAR at the arterial phase, venous phase and delayed phase were shown to be useful CT attenuation parameter in discriminating RO from chRCC when histologic evaluation on biopsy is indeterminate.
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21
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Kravtsov O, Gupta S, Cheville JC, Sukov WR, Rowsey R, Herrera-Hernandez LP, Lohse CM, Knudson R, Leibovich BC, Jimenez RE. Low-Grade Oncocytic Tumor of Kidney (CK7-Positive, CD117-Negative): Incidence in a single institutional experience with clinicopathological and molecular characteristics. Hum Pathol 2021; 114:9-18. [PMID: 33961838 DOI: 10.1016/j.humpath.2021.04.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/22/2021] [Accepted: 04/28/2021] [Indexed: 01/06/2023]
Abstract
Low-grade oncocytic tumor of the kidney (LOT) is characterized by cytoplasmic eosinophilia and a CK7-positive/CD117-negative immunophenotype. Morphologically, they exhibit overlapping features with oncocytoma and chromophobe renal cell carcinoma. Our aim was to obtain long-term clinical follow-up data, clinicopathological and molecular characteristics, and incidence of LOT. Tissue microarrays were constructed from 574 tumors historically diagnosed as oncocytoma and surgically treated at Mayo Clinic between 1970 and 2012, and immunostained for CK7 and CD117. An extended immunophenotype was obtained on whole slide sections, along with FISH for CCND1 rearrangement status and chromosomal microarray for copy number status. In addition, two cases were retrospectively identified in a set of tuberous sclerosis complex (TSC)-associated neoplasms and three more cases diagnosed on needle core biopsies were obtained during routine clinical practice. Twenty-four cases of LOT were identified among 574 consecutive tumors diagnosed as oncocytoma and treated with partial or radical nephrectomy, corresponding to an incidence of 4.18% of tumors historically diagnosed as oncocytomas, and 0.35% of 6944 nephrectomies performed between 1970 and 2012. Overall, 29 cases of LOT were identified in three clinical settings: sporadic, TSC-associated, and end-stage renal disease (ESRD). Multifocality was seen only in the setting of TSC and ESRD. No metastases attributable to LOT were identified (median follow-up 9.6 years). There were no recurrent arm level copy number changes detected by chromosomal microarray and all tested cases were negative for CCND1 rearrangement by FISH. LOT is an uncommon eosinophilic renal neoplasm with an indolent prognosis that constitutes ∼4% of tumors historically diagnosed as oncocytoma. The morphologic, immunophenotypic, and molecular features of this neoplasm suggest it is a distinct entity of renal neoplasia.
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Affiliation(s)
- Oleksandr Kravtsov
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Sounak Gupta
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - John C Cheville
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - William R Sukov
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Ross Rowsey
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Christine M Lohse
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, USA
| | - Ryan Knudson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Rafael E Jimenez
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA.
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22
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Neves JB, Vanaclocha Saiz L, Abu-Ghanem Y, Marchetti M, Tran-Dang MA, El-Sheikh S, Barod R, Beisland C, Capitanio U, Cullen D, Klatte T, Ljungberg B, Mumtaz F, Patki P, Stewart GD, Dabestani S, Tran MGB, Bex A. Pattern, timing and predictors of recurrence after surgical resection of chromophobe renal cell carcinoma. World J Urol 2021; 39:3823-3831. [PMID: 33851271 DOI: 10.1007/s00345-021-03683-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/24/2021] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Currently there are no specific guidelines for the post-operative follow-up of chromophobe renal cell carcinoma (chRCC). We aimed to evaluate the pattern, location and timing of recurrence after surgery for non-metastatic chRCC and establish predictors of recurrence and cancer-specific death. METHODS Retrospective analysis of consecutive surgically treated non-metastatic chRCC cases from the Royal Free London NHS Foundation Trust (UK, 2015-2019) and the international collaborative database RECUR (15 institutes, 2006-2011). Kaplan-Meier curves were plotted. The association between variables of interest and outcomes were analysed using univariate and multivariate Cox proportional hazards regression models with shared frailty for data source. RESULTS 295 patients were identified. Median follow-up was 58 months. The five and ten-year recurrence-free survival rates were 94.3% and 89.2%. Seventeen patients (5.7%) developed recurrent disease, 13 (76.5%) with distant metastases. 54% of metastatic disease diagnoses involved a single organ, most commonly the bone. Early recurrence (< 24 months) was observed in 8 cases, all staged ≥ pT2b. 30 deaths occurred, of which 11 were attributed to chRCC. Sarcomatoid differentiation was rare (n = 4) but associated with recurrence and cancer-specific death on univariate analysis. On multivariate analysis, UICC/AJCC T-stage ≥ pT2b, presence of coagulative necrosis, and positive surgical margins were predictors of recurrence and cancer-specific death. CONCLUSION Recurrence and death after surgically resected chRCC are rare. For completely excised lesions ≤ pT2a without coagulative necrosis or sarcomatoid features, prognosis is excellent. These patients should be reassured and follow-up intensity curtailed.
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Affiliation(s)
- Joana B Neves
- Division of Surgery and Interventional Science, University College London, London, UK
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | | | - Yasmin Abu-Ghanem
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | - Marta Marchetti
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | - My-Anh Tran-Dang
- Department of Pathology, Royal Free London NHS Foundation Trust, London, UK
| | - Soha El-Sheikh
- Department of Pathology, Royal Free London NHS Foundation Trust, London, UK
| | - Ravi Barod
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | - Christian Beisland
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Urology, Haukeland University Hospital, Bergen, Norway
| | - Umberto Capitanio
- Department of Urology and Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - David Cullen
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | - Tobias Klatte
- Department of Urology, Royal Bournemouth Hospital, Bournemouth, UK
- Department of Surgery, University of Cambridge, Cambridge, UK
| | - Börje Ljungberg
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - Faiz Mumtaz
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | - Prasad Patki
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | - Grant D Stewart
- Department of Surgery, University of Cambridge, Cambridge, UK
| | - Saeed Dabestani
- Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Maxine G B Tran
- Division of Surgery and Interventional Science, University College London, London, UK
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK
| | - Axel Bex
- Division of Surgery and Interventional Science, University College London, London, UK.
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond street, London, NW3 2QG, UK.
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23
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Zoumpourlis P, Genovese G, Tannir NM, Msaouel P. Systemic Therapies for the Management of Non-Clear Cell Renal Cell Carcinoma: What Works, What Doesn't, and What the Future Holds. Clin Genitourin Cancer 2021; 19:103-116. [PMID: 33358151 PMCID: PMC8169717 DOI: 10.1016/j.clgc.2020.11.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/31/2020] [Accepted: 11/18/2020] [Indexed: 02/06/2023]
Abstract
Non-clear cell renal cell carcinoma (nccRCC) is a broad term that refers to a diverse group of tumors, each with its own distinct biologic and therapeutic profile. The management of nccRCCs is often based on extrapolating data from clinical trials in the more common clear cell renal cell carcinoma, but our emerging prospective and retrospective clinical experience in nccRCC allows us to make more precise recommendations tailored to each histology. The systemic therapy options for metastatic nccRCC include targeted therapies such as tyrosine kinase inhibitors, immune checkpoint inhibitors, and, for specific rare subtypes, cytotoxic chemotherapy. Each nccRCC histology may respond differently to these regimens, which makes accurate pathologic diagnosis imperative. In the present review, we discuss the available clinical and biological data that can help guide systemic therapy recommendations for specific nccRCC subtypes.
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Affiliation(s)
| | - Giannicola Genovese
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Nizar M Tannir
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Pavlos Msaouel
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX; Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX.
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24
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Garje R, Elhag D, Yasin HA, Acharya L, Vaena D, Dahmoush L. Comprehensive review of chromophobe renal cell carcinoma. Crit Rev Oncol Hematol 2021; 160:103287. [PMID: 33753250 DOI: 10.1016/j.critrevonc.2021.103287] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 11/27/2020] [Accepted: 02/27/2021] [Indexed: 12/12/2022] Open
Abstract
Chromophobe renal cell carcinoma (chRCC) is the third most common type of RCC with distinct biology compared to other kidney cancer subtypes. The heterogeneity between the RCC subtypes is associated with noticeable differences in tumor aggressiveness and risk for the development of metastatic disease. ChRCC is characterized by chromosomal aneuploidy, TP53, PTEN, and mitochondrial gene mutations. Though the therapeutic landscape of clear cell RCC (ccRCC) has significantly evolved over the past decade, limited progress has been seen in chRCC due to its infrequent incidence. In fact, the therapeutic approach for chRCC is often extrapolated from ccRCC treatments or studies that combine several forms of nccRCC subtypes. In the new era of genetic profiling of tumors and targeted therapeutics, this review describes the epidemiology, pathology, molecular characteristics, and current management with ongoing clinical trials for chRCC.
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Affiliation(s)
- Rohan Garje
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, United States; Department of Internal Medicine, University of Iowa, Iowa City, IA, United States.
| | - Dean Elhag
- Department of Internal Medicine, University of Iowa, Iowa City, IA, United States
| | - Hesham A Yasin
- Department of Internal Medicine, University of Iowa, Iowa City, IA, United States
| | - Luna Acharya
- Department of Internal Medicine, University of Iowa, Iowa City, IA, United States
| | - Daniel Vaena
- West Cancer Center and Research Institute, University of Tennessee, University of Iowa, United States
| | - Laila Dahmoush
- Department of Pathology and Urology, University of Iowa, Iowa City, IA, United States
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25
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Khauli M, Heidar NA, Degheili JA, Hakam N, Al-Moussawy M, Shahait M, El-Asmar J, Bustros G, Merhe A, Nasr R, Bulbul M, Wazzan W, El-Hajj A, Shamseddine A, Kfoury H, Mukherji D, Khauli R. Comparative analysis of histopathological subtypes of renal cell carcinoma in the Middle East compared to other world regions. Urol Ann 2021; 13:130-133. [PMID: 34194138 PMCID: PMC8210716 DOI: 10.4103/ua.ua_172_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction Renal cell carcinoma (RCC) has various histopathological tumor subtypes which have a significant implication on the oncological outcome of these patients. We aimed to evaluate the distribution of RCC subtypes presenting at a tertiary care center in the Middle East, in comparison to the distribution reported in different geographic areas worldwide. Methods A retrospective chart review was conducted on all patients who underwent partial or radical nephrectomy for RCC at the American University of Beirut Medical Center between January 2012 and January 2018. Data on histologic subtypes were compiled and compared to representative series from different continents. Results One hundred and seventy-nine patients with RCC were identified, of whom 122 (68.2%) were classified as clear cell, 30 (16.8%) as papillary, 17 (9.5%) as chromophobe, and 10 (5.6%) as unclassified. When compared to other regions of the world, this Middle Eastern series demonstrated a higher prevalence of the chromophobe subtype compared to Western populations (9.5% in the Middle East vs. 5.3% in the US and 3.1% in Europe) and a lower prevalence of clear cell subtype (68.2% in the Middle East vs. 78.7% in the US and 85.8% in Europe). Conversely, there was a higher prevalence of papillary RCC in the Middle East (16.8%) compared to North America (13.1%, 95% confidence interval [CI]: 12.7-13.6), Europe (11.1%, 95% CI: 10.0-12.1), and Australia (10.2%). The prevalence of chromophobe and clear cell RCC in the Middle East was similar to that reported in South America. Conclusions The distribution of RCC subtypes in this Middle Eastern cohort was significantly different from that reported in the Western hemisphere (Europe and the US) but similar to that reported in South America and Australia. These findings may point to a possible genetic predisposition underlying the global variation in distribution.
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Affiliation(s)
- Mark Khauli
- Department of Surgery, Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Nicosia, Cyprus.,Faculty of Medicine, St. George's University of London Medical School, Nicosia University, Nicosia, Cyprus
| | - Nassib Abou Heidar
- Department of Surgery, Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Nicosia, Cyprus
| | - Jad A Degheili
- Department of Surgery, Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Nicosia, Cyprus
| | - Nizar Hakam
- Department of Surgery, Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Nicosia, Cyprus
| | - Mouhamad Al-Moussawy
- Department of Surgery, Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Nicosia, Cyprus
| | - Mohammed Shahait
- Department of General Surgery, Division of Urology, King Hussein Cancer Center, Amman, Jordan
| | - Jose El-Asmar
- Department of Surgery, Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Nicosia, Cyprus
| | - Gerges Bustros
- Department of Surgery, Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Nicosia, Cyprus
| | - Ali Merhe
- Department of Surgery, Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Nicosia, Cyprus
| | - Rami Nasr
- Department of Surgery, Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Nicosia, Cyprus
| | - Muhammad Bulbul
- Department of Surgery, Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Nicosia, Cyprus
| | - Wassim Wazzan
- Department of Surgery, Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Nicosia, Cyprus
| | - Albert El-Hajj
- Department of Surgery, Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Nicosia, Cyprus
| | - Ali Shamseddine
- Department of Internal Medicine, Hematology-Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hala Kfoury
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Deborah Mukherji
- Department of Internal Medicine, Hematology-Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon
| | - Raja Khauli
- Department of Surgery, Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Nicosia, Cyprus
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26
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Mehra K, Manikandan R, Dorairajan LN, Sreerekha J. A rare case of giant chromophobe renal cell carcinoma with sarcomatoid differentiation: Treatment and prognosis. J Cancer Res Ther 2021; 17:602-605. [PMID: 34121720 DOI: 10.4103/jcrt.jcrt_1051_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Chromophobe renal cell carcinoma (RCC) with sarcomatoid differentiation is an infrequent entity. In the current era of advanced imaging techniques, RCCs are usually detected in early stages, and a localized giant tumor is rarely encountered. Recently, we encountered a patient with a localized giant RCC, which was 36 cm in the largest dimension and weighing 5.1 kg, which was resected entirely but presented relapse and succumbed within 3 months of surgery.
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Affiliation(s)
- Ketan Mehra
- Department of Urology, JIPMER, Puducherry, India
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27
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Molnar A, Yusenko MV, Kovacs G, Banyai D. The Role of Genetic Analysis in Correct Diagnosis of Eosinophilic Variant of Chromophobe Renal Cell Carcinoma. Anticancer Res 2020; 40:6863-6867. [PMID: 33288578 DOI: 10.21873/anticanres.14708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/09/2020] [Accepted: 10/15/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM It has been suggested that eosinophilic variant of chromophobe renal cell carcinoma (chRCC) with low chromosome number or lack of genomic alteration has an excellent prognosis in comparison to classic chRCC. The aim of our study was to analyse the phenotypical variations of 77 chRCCs, including 7 eosinophilic ones, each diagnosed unequivocally by genetic means. MATERIALS AND METHODS DNA isolated from chRCCs was subjected to array comparative genomic hybridisation (CGH) for establishing the chromosome alteration. Original histological slides were evaluated for cellular phenotype and growth pattern and compared to the genetic alterations. RESULTS Loss of the entire chromosome 1, 2, 6, 10, 13, 17 and 21 occurred in 95%, 94%, 86% 90% 82% 90% and 66% of the cases, respectively. The number of chromosome alterations in eosinophilic forms of chRCC corresponded to those found in classic chRCC with pale-reticular cytoplasm or mixed cellular characteristics. Three of seven eosinophilic variants with loss of 4, 10 and 11 chromosomes showed metastasis at the time of diagnosis whereas only 3 metastatic tumors were noticed among the 70 classic chRCC. We did not find discriminating difference in number of chromosome alteration between classic and eosinophilic forms of chRCC. CONCLUSION Eosinophilic chRCC has a more aggressive biology than the classic form. To avoid diagnostic pitfall of eosinophilic renal cell tumors with uncertain diagnosis, a genetic analysis should be carried out.
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Affiliation(s)
- Agnes Molnar
- Department of Urology, Medical School, University of Pecs, Pecs, Hungary
| | - Maria V Yusenko
- Institute of Biochemistry, University of Muenster, Muenster, Germany
| | - Gyula Kovacs
- Department of Urology, Medical School, University of Pecs, Pecs, Hungary; .,Medical Faculty, Ruprecht-Karls-University, Heidelberg, Germany
| | - Daniel Banyai
- Department of Urology, Medical School, University of Pecs, Pecs, Hungary
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28
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Karashima T, Kuroda N, Taguchi T, Fukuhara H, Kuno T, Tamura K, Hiroi M, Inoue K, Yamaguchi T. Oncocytic variant, a novel subtype of chromophobe renal cell carcinoma: a report of two cases and a literature review. Int Cancer Conf J 2020; 10:100-106. [PMID: 33782641 PMCID: PMC7947131 DOI: 10.1007/s13691-020-00459-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/14/2020] [Indexed: 12/01/2022] Open
Abstract
A novel variant of chromophobe renal cell carcinoma showing an oncocytic phenotype is proposed. Two new cases of this rare entity are presented and discussed along with six previous cases from our colleagues. A 76-year-old man and a 78-year-old man had a 3.4-cm and a 3.2-cm-diameter renal mass, respectively. On histopathological examination of surgical specimens, uniform eosinophilic cuboidal cells without a perinuclear halo growing in a tubular pattern were seen, and differential diagnosis from oncocytoma was necessary. Immunohistochemical staining for cytokeratin 7 and E-cadherin showed diffusely positive patterns in both, as in the previous reports. Although monosomy of chromosomes 7, 10, 13, and 17 was commonly observed in the previous reports, gains of chromosome 19 were observed in the two present cases. Immunohistochemical and cytogenetic approaches lead to exclusion of oncocytoma and the diagnosis of an oncocytic variant of chromophobe renal cell carcinoma.
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Affiliation(s)
- Takashi Karashima
- Department of Urology, Kochi Medical School, Kochi University, Kohasu, Oko, Nankoku, Kochi, 783-8505 Japan
| | - Naoto Kuroda
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi, 780-0062 Japan
| | - Takahiro Taguchi
- Human Health and Medical Science, Faculty of Medicine, Kochi University, Nankoku, 783-8505 Japan
| | - Hideo Fukuhara
- Department of Urology, Kochi Medical School, Kochi University, Kohasu, Oko, Nankoku, Kochi, 783-8505 Japan
| | - Takahira Kuno
- Department of Urology, Kochi Medical School, Kochi University, Kohasu, Oko, Nankoku, Kochi, 783-8505 Japan
| | - Kenji Tamura
- Department of Urology, Kochi Medical School, Kochi University, Kohasu, Oko, Nankoku, Kochi, 783-8505 Japan
| | - Makoto Hiroi
- Laboratory of Diagnostic Pathology, Kochi Medical School Hospital, Nankoku, 783-8505 Japan
| | - Keiji Inoue
- Department of Urology, Kochi Medical School, Kochi University, Kohasu, Oko, Nankoku, Kochi, 783-8505 Japan
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29
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McGillivray PD, Ueno D, Pooli A, Mendhiratta N, Syed JS, Nguyen KA, Schulam PG, Humphrey PA, Adeniran AJ, Boutros PC, Shuch B. Distinguishing Benign Renal Tumors with an Oncocytic Gene Expression (ONEX) Classifier. Eur Urol 2021; 79:107-11. [PMID: 32972793 DOI: 10.1016/j.eururo.2020.09.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/04/2020] [Indexed: 01/09/2023]
Abstract
Renal oncocytoma (RO) accounts for 5% of renal cancers and generally behaves as a benign tumor with favorable long-term prognosis. It is difficult to confidently distinguish between benign RO and other renal malignancies, particularly chromophobe renal cell carcinoma (chRCC). Therefore, RO is often managed aggressively with surgery. We sought to identify molecular biomarkers to distinguish RO from chRCC and other malignant renal cancer mimics. In a 44-patient discovery cohort, we identified a significant differential abundance of nine genes in RO relative to chRCC. These genes were used to train a classifier to distinguish RO from chRCC in an independent 57-patient cohort. The trained classifier was then validated in five independent cohorts comprising 89 total patients. This nine-gene classifier trained on the basis of differential gene expression showed 93% sensitivity and 98% specificity for distinguishing RO from chRCC across the pooled validation cohorts, with a c-statistic of 0.978. This tool may be a useful adjunct to other diagnostic modalities to decrease the diagnostic and management uncertainty associated with small renal masses and to enable clinicians to recommend more confidently less aggressive management for some tumors. PATIENT SUMMARY: Renal oncocytoma is generally a benign form of kidney cancer that does not necessarily require surgical removal. However, it is difficult to distinguish renal oncocytoma from other more aggressive forms of kidney cancer, so it is treated most commonly with surgery. We built a classification tool based on the RNA levels of nine genes that may help avoid these surgeries by reliably distinguishing renal oncocytoma from other forms of kidney cancer.
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30
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Guo Q, Liu N, Wang F, Guo Y, Yang B, Cao Z, Wang Y, Wang Y, Zhang W, Huang Q, Zhao W, Liu C, Qu T, Li L, Cao L, Ren D, Meng B, Qi L, Wang C, Cao W. Characterization of a distinct low-grade oncocytic renal tumor (CD117-negative and cytokeratin 7-positive) based on a tertiary oncology center experience: the new evidence from China. Virchows Arch 2020; 478:449-458. [PMID: 32918598 DOI: 10.1007/s00428-020-02927-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/23/2020] [Accepted: 09/02/2020] [Indexed: 12/19/2022]
Abstract
To examine the clinicopathologic and immunohistochemical features of a group of newly defined low-grade oncocytic renal tumors (LOT) that have the "CD117 negative/cytokeratin (CK)7 positive" immunoprofile. We have queried our hospital database and found 4456 consecutive renal tumors between 2016 and 2019. Among these renal tumors, eight (8) cases meet the morphologic and immunohistochemical characterization for low-grade oncocytic renal tumor (LOT). The eight (8) patients' mean age is 56.6 years (range 39-70 years old), and the male to female ratio is 1:1. Macroscopically, these LOTs generally present with tan-brown and solid cut surfaces and demonstrate similar solid, compact nested growth pattern microscopically. Tumor cells exhibit oncocytic cytoplasm and uniformly rounded to oval nuclei. There are areas of edematous stroma containing dispersed single or small clustered tumor cells. All tumors are negative for CD117 and positive for CK7. Uniform reactivity is also found for BerEP4, cyclin D1, and SDHB. Besides, CD10, vimentin, and AMACR are either negative or only focally positive. All of the tumors are negative for CA9 and TFE. The Ki-67 index is less than 5% in the seven (7) internal cases. Seven (7) of the eight (8) patients who are available for follow-up are alive and without disease recurrence (mean follow-up period of 21.6 months, ranging from 6 to 43 months). We described a group of low-grade oncocytic renal tumors identified retrospectively in a large tertiary cancer center, which was probably the first report originated from China or even Asia in the English literature so far. These tumors demonstrated eosinophilic cytoplasm and low-grade appearing nuclei with a "CD117 negative/CK7 positive" immunoprofile. The incidence rate was about 3.7% of the oncocytic renal tumors and 0.18% of all the renal tumors that were received in our lab during the four-year period. It is necessary to separate this group of tumors by its characteristic morphologic and immunophenotypic features.
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Affiliation(s)
- Qianru Guo
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Ning Liu
- Tianjin Baodi Hospital/Baodi Clinical College of Tianjin Medical University, Tianjin, People's Republic of China
| | - Frank Wang
- McMaster University, Hamilton, Ontario, Canada
| | - Yuhong Guo
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Bo Yang
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Zi Cao
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Yalei Wang
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Yong Wang
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Wenshuai Zhang
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Qiujuan Huang
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Wei Zhao
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Changxu Liu
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Tongyuan Qu
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Lingmei Li
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Lu Cao
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Danyang Ren
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Bin Meng
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Lisha Qi
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China
| | - Cheng Wang
- QEII Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Wenfeng Cao
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Ministry of Education, Tianjin, 300060, People's Republic of China.
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31
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An J, Park CK, Kim M, Joo JW, Cho NH. HNF-1β as an immunohistochemical marker for distinguishing chromophobe renal cell carcinoma and hybrid oncocytic tumors from renal oncocytoma. Virchows Arch 2020; 478:459-470. [PMID: 32816058 DOI: 10.1007/s00428-020-02912-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/04/2020] [Accepted: 08/11/2020] [Indexed: 11/24/2022]
Abstract
The histologic features of renal oncocytoma (RO) are similar to those for the more aggressive chromophobe renal cell carcinoma (ChRCC). To assess immunohistochemical markers of the two, the sensitivity and specificity of cytokeratin 7 (CK7) and C-kit, as well as hepatocyte nuclear factor-1β (HNF-1β), were analyzed. Typical cases of ChRCC and RO at Severance Hospital between July 2014 and July 2018 were selected retrospectively. Among 44 cases, 17 were unanimously compatible with ChRCC, 16 were RO, and 11 cases were indeterminate. Samples from all selected cases were used for immunostaining with antibodies against CK7, C-kit, HNF-1β, and CD10. Immunostaining demonstrated complete loss of HNF-1β expression in 11 out of 17 (64.7%) ChRCC cases and a partial, but significant loss in > 50% of tumor cells in the remaining 6 cases (35.3%). In contrast, HNF-1β expression was preserved in tumor cells of RO cases. Fourteen of 17 ChRCC cases (82.4%) were diffusely positive for CK7, whereas cases of RO were focal positive or negative. C-kit staining did not show a significant difference between ChRCC and RO. Two of five ChRCC cases showing diffuse immunoreactivity for CD10 had poor prognoses of local invasion, distant metastasis, or death. Loss of HNF-1β expression is a useful marker with which to diagnose ChRCC, especially in cases with confusing histologic findings or equivocal CK7 staining. Additionally, CD10 staining in high-grade ChRCC aids in diagnosis and prediction of the clinical prognosis.
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MESH Headings
- Adenoma, Oxyphilic/chemistry
- Adenoma, Oxyphilic/mortality
- Adenoma, Oxyphilic/pathology
- Adenoma, Oxyphilic/therapy
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/analysis
- Carcinoma, Renal Cell/chemistry
- Carcinoma, Renal Cell/mortality
- Carcinoma, Renal Cell/pathology
- Carcinoma, Renal Cell/therapy
- Diagnosis, Differential
- Down-Regulation
- Female
- Hepatocyte Nuclear Factor 1-beta/analysis
- Humans
- Immunohistochemistry
- Keratin-7/analysis
- Kidney Neoplasms/chemistry
- Kidney Neoplasms/mortality
- Kidney Neoplasms/pathology
- Kidney Neoplasms/therapy
- Male
- Middle Aged
- Predictive Value of Tests
- Prognosis
- Proto-Oncogene Proteins c-kit/analysis
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Affiliation(s)
- Jiyeon An
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Cheol Keun Park
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Moonsik Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Jin Woo Joo
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Nam Hoon Cho
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Tong K, Hu Z. FOXI1 expression in chromophobe renal cell carcinoma and renal oncocytoma: a study of The Cancer Genome Atlas transcriptome-based outlier mining and immunohistochemistry. Virchows Arch 2020; 478:647-658. [PMID: 32812119 DOI: 10.1007/s00428-020-02900-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/19/2020] [Accepted: 08/06/2020] [Indexed: 01/09/2023]
Abstract
FOXI1 is a forkhead family transcription factor that plays a key role in differentiation and functional maintenance for the renal intercalated cell (IC). The diagnostic utility of FOXI1 is rarely studied thus far. Comparative analyses of FOXI1 mRNA expression in normal kidney tissue and different renal neoplasms including chromophobe renal cell carcinoma (chRCC), renal oncocytoma (RO), and other renal cell carcinomas were conducted using transcriptomic data from The Cancer Genome Atlas (TCGA), Gene Expression Omnibus, and single-cell RNA-seq datasets, in combination with integrative analyses using mutant data, karyotype data, and digital slides for cases with anomalous FOXI1 expression in TCGA. Formalin-fixed, paraffin-embedded whole-tissue slides of varied primary renal neoplasms (n = 367) were subjected to FOXI1 staining for validating FOXI1 transcription levels. We confirmed that FOXI1 was significantly upregulated at mRNA levels in ICs, chRCCs, and ROs compared with other renal tubule cell and renal cell carcinoma subtypes. Furthermore, most of the cases with FOXI1 expression outliers were misclassified in the TCGA kidney cancer project. An underlying novel entity with frequent mutations involved in the mTOR pathway was also found. FOXI1 immunoreactivity was consistently noted in ICs of the distal nephron. FOXI1 staining was positive in 85 of 93 chRCCs and 13 of 18 ROs, respectively. FOXI1 staining was not seen in renal neoplasms (n = 254) derived from non-ICs. In conclusion, FOXI1 expression in normal kidney tissue is restricted to ICs. This cell type-specific expression is retained during neoplastic transformation from ICs to chRCCs or ROs. FOXI1 is thereby a potential biomarker of IC-related tumors.
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Affiliation(s)
- Kuo Tong
- Department of Pathology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410078, Hunan, China.,Department of Pathology, The Bishan Hospital of Chongqing, Bishan District, Chongqing, 402760, China.,Department of Pathology, School of Basic Medical Science, Central South University, 172 Tongzi Road, Changsha, 410013, Hunan, China
| | - Zhongliang Hu
- Department of Pathology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410078, Hunan, China. .,Department of Pathology, School of Basic Medical Science, Central South University, 172 Tongzi Road, Changsha, 410013, Hunan, China.
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33
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Yang F, Zhao ZC, Hu AJ, Sun PF, Zhang B, Yu MC, Wang J. Synchronous sporadic bilateral multiple chromophobe renal cell carcinoma accompanied by a clear cell carcinoma and a cyst: A case report. World J Clin Cases 2020; 8:3064-3073. [PMID: 32775388 PMCID: PMC7385615 DOI: 10.12998/wjcc.v8.i14.3064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/01/2020] [Accepted: 06/25/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Renal cell carcinomas are usually unilateral. However, they are bilateral in 2% to 4% of sporadic cases and is considerably more common in familial cases. Synchronous sporadic bilateral multiple chromophobe renal cell carcinoma (CHRCC) with different subtypes is rare.
CASE SUMMARY In this case report, we describe a case of synchronous bilateral CHRCC with two histological variants, accompanied by a clear cell carcinoma and a cyst in a 50-year-old male. The patient underwent retroperitoneal laparoscopic bilateral nephron-sparing surgery and there was no serious postoperative renal dysfunction.
CONCLUSION We report a rare case of synchronous bilateral CHRCC with two histological variants associated with a clear cell carcinoma and a cyst.
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Affiliation(s)
- Fan Yang
- Department of Radiology, Peking University Shougang Hospital, Beijing 100144, China
| | - Zi-Chen Zhao
- Department of Urinary Surgery, Peking University Shougang Hospital, Beijing 100144, China
| | - A-Jin Hu
- Department of Pathology, Peking University Shougang Hospital, Beijing 100144, China
| | - Peng-Fei Sun
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Bin Zhang
- Department of Radiology, Peking University Shougang Hospital, Beijing 100144, China
| | - Ming-Chuan Yu
- Department of Radiology, Peking University Shougang Hospital, Beijing 100144, China
| | - Juan Wang
- Department of Radiology, Peking University Shougang Hospital, Beijing 100144, China
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34
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Abstract
Indeterminate renal masses remain a diagnostic challenge for lesions not initially characterized as angiomyolipoma or Bosniak I/II cysts. Differential for indeterminate renal masses include oncocytoma, fat-poor angiomyolipoma, and clear cell, papillary, and chromophobe renal cell carcinoma. Qualitative and quantitative techniques using data derived from multiphase contrast-enhanced imaging have provided methods for specific differentiation and subtyping of indeterminate renal masses, with emerging applications such as radiocytogenetics. Early and accurate characterization of indeterminate renal masses by multiphase contrast-enhanced imaging will optimize triage of these lesions into surgical, ablative, and active surveillance treatment plans.
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35
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Di Mauro I, Ambrosetti D, Vignot L, Roussel JF, Dadone-Montaudie B, Peyron AC, Quintens H, Durand M, Amiel J, Pedeutour F. Detection of tetraploidization in chromophobe renal cell carcinoma: Insights and pitfalls. Genes Chromosomes Cancer 2020; 59:675-687. [PMID: 32658344 DOI: 10.1002/gcc.22886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/10/2020] [Accepted: 07/10/2020] [Indexed: 11/07/2022] Open
Abstract
Chromosomal losses resulting in a marked hypodiploidy are a specificity of chromophobe renal cell carcinoma (ChRCC), the third most frequent type of kidney cancer. Its detection is useful in challenging cases. However some ChRCC, especially the eosinophilic variant, do not exhibit hypodiploidy and deserve to be better explored. Using comparative genomic hybridization (array-CGH) we observed chromosomal gains in five cases of nonmetastatic ChRCC. Our objective was to determine whether these apparent chromosomal gains were instead losses within a near-polyploid genome. We performed a retrospective and prospective molecular study of 26 cases of ChRCC retrieved among 643 renal tumors (2012-2019). All tumors were analyzed using array-CGH (Agilent) and array-CGH (Affymetrix) coupled to single nucleotide polymorphism analysis (array-SNP). In silico manual centralization of the fluorescence ratio, fluorescence in situ hybridization (FISH) and next generation sequencing were made in the five cases suspected of polyploidy. Tetraploidization was observed in 19% of our series of ChRCC. None of the methods used individually could identify both chromosomal losses and tetraploidy. Only the combination of manual recentring of array-CGH and FISH provided relevant results. B-allele frequency results indicated that tetraploidization occurred secondarily to chromosomal losses in four cases while it preceded losses in one case. Tetraploidization is a frequent but underestimated phenomenon in ChRCC that may be overlooked using the individual standard genomic methods. Its potential clinical consequences are not identified yet. Whether the mechanisms that induce chromosomal losses in ChRCC are the same that generate tetraploidization is not known.
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Affiliation(s)
- Ilaria Di Mauro
- Laboratory of Solid Tumor Genetics, University Hospital of Nice-Côte d'Azur University, Nice, France
- Laboratory of Solid Tumor Genetics, Institute for Research on Cancer and Aging of Nice (IRCAN), Nice, France
| | - Damien Ambrosetti
- Laboratory of Solid Tumor Genetics, Institute for Research on Cancer and Aging of Nice (IRCAN), Nice, France
- Central Laboratory of Pathology, University Hospital of Nice-Côte d'Azur University, Nice, France
| | - Louis Vignot
- Laboratory of Solid Tumor Genetics, Institute for Research on Cancer and Aging of Nice (IRCAN), Nice, France
- Department of Urology, University Hospital of Nice-Côte d'Azur University, Nice, France
| | | | - Bérengère Dadone-Montaudie
- Laboratory of Solid Tumor Genetics, University Hospital of Nice-Côte d'Azur University, Nice, France
- Laboratory of Solid Tumor Genetics, Institute for Research on Cancer and Aging of Nice (IRCAN), Nice, France
- Central Laboratory of Pathology, University Hospital of Nice-Côte d'Azur University, Nice, France
| | - Annie-Claude Peyron
- Laboratory of Solid Tumor Genetics, University Hospital of Nice-Côte d'Azur University, Nice, France
- Laboratory of Solid Tumor Genetics, Institute for Research on Cancer and Aging of Nice (IRCAN), Nice, France
| | - Hervé Quintens
- Department of Urology, Princess Grace Hospital, Monaco, Monaco
| | - Matthieu Durand
- Laboratory of Solid Tumor Genetics, Institute for Research on Cancer and Aging of Nice (IRCAN), Nice, France
- Department of Urology, University Hospital of Nice-Côte d'Azur University, Nice, France
| | - Jean Amiel
- Laboratory of Solid Tumor Genetics, Institute for Research on Cancer and Aging of Nice (IRCAN), Nice, France
- Department of Urology, University Hospital of Nice-Côte d'Azur University, Nice, France
| | - Florence Pedeutour
- Laboratory of Solid Tumor Genetics, University Hospital of Nice-Côte d'Azur University, Nice, France
- Laboratory of Solid Tumor Genetics, Institute for Research on Cancer and Aging of Nice (IRCAN), Nice, France
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36
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Simon AG, Esser LK, Ellinger J, Branchi V, Tolkach Y, Müller S, Ritter M, Kristiansen G, Muders MH, Mayr T, Toma MI. Targeting glycolysis with 2-deoxy-D-glucose sensitizes primary cell cultures of renal cell carcinoma to tyrosine kinase inhibitors. J Cancer Res Clin Oncol 2020; 146:2255-2265. [PMID: 32533404 DOI: 10.1007/s00432-020-03278-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 05/30/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE To investigate the synergistic effect of glycolysis inhibition on therapy answer to tyrosine kinase inhibitors in renal carcinoma. METHODS Primary cell cultures from 33 renal tumors including clear cell RCC (ccRCC), papillary RCC and the rare subtype chromophobe RCC as well as two metastases of ccRCC were obtained and cultivated. The patient-derived cells were verified by immunohistochemistry. CcRCC cells were further examined by exon sequencing of the von Hippel-Lindau gene (VHL) and by RNA-sequencing. Next, cell cultures of all subtypes of RCC were exposed to increasing doses of various tyrosine kinase inhibitors (axitinib, cabozantinib and pazopanib) and the glycolysis inhibitor 2-deoxy-D-glucose, alone or combined. CellTiter-Glo® Luminescence assay and Crystal Violet staining were used to assess the inhibition of glycolysis and the viability of the cultured primary cells. RESULTS The cells expressed characteristic tissue markers and, in case of ccRCC cultures, the VHL status of the tumor they derived from. An upregulation of HK1, PFKP and SLC2A1 was observed, while components of the respiratory chain were downregulated, confirming a metabolic shift towards aerobic glycolysis. The tumors displayed variable individual responses for the therapeutics. All subtypes of RCC were susceptible to cabozantinib treatment indicated by decreased proliferation. Adding 2-deoxy-D-glucose to tyrosine kinase inhibitors decreased ATP production and increased the susceptibility of ccRCC to pazopanib treatment. CONCLUSION This study presents a valuable tool to cultivate even uncommon and rare renal cancer subtypes and allows testing of targeted therapies as a personalized approach as well as testing new therapies such as glycolysis inhibition in an in vitro model.
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Affiliation(s)
- Adrian Georg Simon
- Department of Pathology, Institute of Pathology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Laura Kristin Esser
- Department of Pathology, Institute of Pathology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Jörg Ellinger
- Department of Urology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Vittorio Branchi
- Department of General, Visceral, Thoracic and Vascular Surgery, Institute of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Yuri Tolkach
- Department of Pathology, Institute of Pathology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Stefan Müller
- Department of Urology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Manuel Ritter
- Department of Urology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Glen Kristiansen
- Department of Pathology, Institute of Pathology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Michael Helmut Muders
- Department of Pathology, Institute of Pathology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Thomas Mayr
- Department of Pathology, Institute of Pathology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Marieta Ioana Toma
- Department of Pathology, Institute of Pathology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
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Abstract
Chromophobe renal cell carcinoma (chRCC) represents 5% of all RCC. ChRCC appears to arise from the distal nephron, in contrast to clear cell RCC that arises from the proximal nephron. ChRCC is distinctive because the tumor cells contain abundant abnormal mitochondria, and frequently have loss of one copy of multiple chromosomes, with a low rate of somatic mutations. Here, we focus on recent discoveries related to genetic and metabolic factors that may promote the progression of chRCC and summarize how these findings may relate to the prognosis and treatment of chRCC.
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Affiliation(s)
- Long Zhang
- Brigham and Women's Hospital, Boston, MA
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38
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Vogelzang NJ, Olsen MR, McFarlane JJ, Arrowsmith E, Bauer TM, Jain RK, Somer B, Lam ET, Kochenderfer MD, Molina A, Doshi G, Lingerfelt B, Hauke RJ, Gunuganti V, Schnadig I, Van Veldhuizen P, Fleming M, Galamaga R, Gupta M, Hool H, Hutson T, Zhang J, McHenry MB, Johansen JL, Tykodi SS. Safety and Efficacy of Nivolumab in Patients With Advanced Non-Clear Cell Renal Cell Carcinoma: Results From the Phase IIIb/IV CheckMate 374 Study. Clin Genitourin Cancer 2020; 18:461-468.e3. [PMID: 32718906 DOI: 10.1016/j.clgc.2020.05.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/30/2020] [Accepted: 05/03/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND The open-label phase IIIb/IV CheckMate 374 study (NCT02596035) was conducted to validate the safety and efficacy of flat-dose nivolumab 240 mg every 2 weeks (Q2W) in previously treated advanced/metastatic renal cell carcinoma. Three cohorts included patients with predominantly clear cell histology, non-clear cell histologies, or brain metastases. We report safety and efficacy from the advanced non-clear cell RCC (nccRCC) cohort of CheckMate 374. METHODS Eligible patients received 0 to 3 prior systemic therapies. Patients received nivolumab 240 mg Q2W for ≤24 months or until confirmed progression or unacceptable toxicity. The primary endpoint was incidence of high-grade (grade 3-5) immune-mediated adverse events (IMAEs). Exploratory endpoints included objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). RESULTS Forty-four patients had advanced nccRCC (papillary [n = 24], chromophobe [n = 7], unclassified [n = 8], other [n = 5]); 34.1% received ≥1 prior systemic regimen in the advanced/metastatic setting. With median follow-up of 11 (range, 0.4-27) months, no all-cause grade 3-5 IMAEs or treatment-related grade 5 adverse events were reported. ORR was 13.6% (95% confidence interval [CI], 5.2-27.4), with 1 complete response (chromophobe) and 5 partial responses (papillary [n = 2], chromophobe [n = 1], collecting duct [n = 1], and unclassified [n = 1] histology). Median PFS was 2.2 months (95% CI, 1.8-5.4). Median OS was 16.3 months (95% CI, 9.2-not estimable). CONCLUSIONS Safety of flat-dose nivolumab 240 mg Q2W was consistent with previous results. Clinically meaningful efficacy was observed with responses in several histologies, supporting nivolumab as a treatment option for patients with advanced nccRCC, a patient population with high unmet need.
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Affiliation(s)
| | - Mark R Olsen
- Medical Oncology, Oklahoma Cancer Specialists, Tulsa, OK
| | | | - Edward Arrowsmith
- Sarah Cannon Research Institute, Tennessee Oncology, PLLC, Chattanooga, TN
| | - Todd M Bauer
- Sarah Cannon Research Institute, Tennessee Oncology, PLLC, Nashville, TN
| | - Rohit K Jain
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | | | - Elaine T Lam
- Medical Oncology, University of Colorado Cancer Center, Aurora, CO
| | | | - Ana Molina
- Department of Medicine, Weill Cornell Medicine, New York, NY
| | | | - Brian Lingerfelt
- Department of Medical Oncology and Hematology, Charleston Oncology, Charleston, SC
| | | | - Vijay Gunuganti
- Department of Oncology, Cancer Care Centers of South Texas, San Antonio, TX
| | | | | | - Mark Fleming
- Virginia Oncology Associates, US Oncology Research, Norfolk, VA
| | - Robert Galamaga
- Department of Hematology/Oncology Illinois Cancer Specialists, Niles, IL
| | - Mukul Gupta
- Department of Medical Oncology and Hematology, Sansum Clinic, Santa Barbara, CA
| | - Hugo Hool
- Department of Oncology and Hematology, Torrance Memorial Medical Center, Torrance, CA
| | - Thomas Hutson
- Texas Oncology, Baylor Charles A. Sammons Cancer Center, Dallas, TX
| | | | | | | | - Scott S Tykodi
- Division of Medical Oncology, University of Washington and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
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Armas-Alvarez AL, Alois Osorio-Manyari A, Donate-Moreno MJ, Vera-Beron R, Salinas-Sánchez AS. Local and distant recurrence of the chromophobe renal cell carcinoma. ARCH ESP UROL 2020; 73:71-75. [PMID: 31950927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION There is still limited knowledgeabout surveillance and optimal management for patientswith recurrent chromophobe renal cell carcinoma. OBJECTIVE: Describe our experience in the diagnosis andmanagement in recurrent chromophobe renal cell carcinoma. MATERIAL AND METHOD Review of medical records ofpatients with chromophobe renal cell carcinoma, selectingthose cases that developed recurrence. RESULTS Of the 23 patients, 4 developed recurrence andwere the subjects of our analysis. The mean age was 61.5years. Surgical treatment of primary renal tumor consistedof three radical nephrectomies and one partial nephrectomy.The mean time from nephrectomy to disease recurrencewas 6.7 years. One patient had recurrence in the retrovesicalarea, another in bone, and the two others in theretroperitoneum. The treatment for retrovesical recurrencewas an incomplete metastasectomy followed by temsirolimusand subsequent removal of the residual mass, stayingstable. The other three cases were unresectable surgicallyand received sunitinib. One patient now has a stable diseaseand the two others died. CONCLUSIONS: Chromophobe renal cell carcinomashowed a greater tendency to metastasize, so requires asurveillance protocol based on the risk of recurrence.
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Affiliation(s)
| | | | | | - Roberto Vera-Beron
- Department of Pathology. University Hospital of Albacete. Albacete. Spain
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40
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Michalova K, Tretiakova M, Pivovarcikova K, Alaghehbandan R, Perez Montiel D, Ulamec M, Osunkoya A, Trpkov K, Yuan G, Grossmann P, Sperga M, Ferak I, Rogala J, Mareckova J, Pitra T, Kolar J, Michal M, Hes O. Expanding the morphologic spectrum of chromophobe renal cell carcinoma: A study of 8 cases with papillary architecture. Ann Diagn Pathol 2019; 44:151448. [PMID: 31918172 DOI: 10.1016/j.anndiagpath.2019.151448] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 11/08/2019] [Indexed: 02/06/2023]
Abstract
Although typically arranged in solid alveolar fashion, chromophobe renal cell carcinoma (RCC) may also show several other architectural growth patterns. We include in this series 8 chromophobe RCC cases with prominent papillary growth, a pattern very rarely reported or only mentioned as a feature of chromophobe RCC, which is lacking wider recognition The differential diagnosis of such cases significantly varies from the typical chromophobe RCC with its usual morphology, particularly its distinction from papillary RCC and other relevant and clinically important entities. Of 972 chromophobe RCCs in our files, we identified 8 chromophobe RCCs with papillary growth. We performed immunohistochemistry and array Comparative Genomic Hybridisation (aCGH) to investigate for possible chromosomal aberrations. Patients were 3 males and 5 females with age ranging from 30 to 84 years (mean 57.5, median 60 years). Tumor size was variable and ranged from 2 to 14 cm (mean 7.5, median 6.6 cm). Follow-up was available for 7 of 8 patients, ranging from 1 to 61 months (mean 20.1, median 12 months). Six patients were alive with no signs of aggressive behavior, and one died of the disease. Histologically, all cases were composed of dual cell population consisting of variable proportions of leaf-like cells with pale cytoplasm and eosinophilic cells. The extent of papillary component ranged from 15 to 100% of the tumor volume (mean 51%, median 50%). Sarcomatoid differentiation was identified only in the case with fatal outcome. Immunohistochemically, all tumors were positive for CK7, CD117 and Hale's Colloidal Iron. PAX8 was positive in 5 of 8 cases, TFE3 was focally positive 3 of 8 tumors, and Cathepsin K was focally positive in 2 of 8 tumors. All cases were negative for vimentin, AMACR and HMB45. Fumarate hydratase staining was retained in all tested cases. The proliferative activity was low (up to 1% in 7, up to 5% in one case). Three cases were successfully analyzed by aCGH and all showed a variable copy number variation profile with multiple chromosomal gains and losses. CONCLUSIONS: Chromophobe RCC demonstrating papillary architecture is an exceptionally rare carcinoma. The diagnosis can be challenging, although the cytologic features are consistent with the classic chromophobe RCC. Given the prognostic and therapeutic implications of accurately diagnosis other RCCs with papillary architecture (i.e., Xp11.2 translocation RCC, FH-deficient RCC), it is crucial to differentiate these cases from chromophobe RCC with papillary architecture. Based on this limited series, the presence of papillary architecture does not appear to have negative prognostic impact. However, its wider recognition may allow in depth studies on additional examples of this rare morphologic variant.
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Affiliation(s)
- Kvetoslava Michalova
- Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic
| | - Maria Tretiakova
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Kristyna Pivovarcikova
- Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic
| | - Reza Alaghehbandan
- Department of Pathology, Faculty of Medicine, University of British Columbia, Royal Columbian Hospital, Vancouver, BC, Canada
| | - Delia Perez Montiel
- Department of Pathology, Institute Nacional de Cancerologia, Mexico City, Mexico
| | - Monika Ulamec
- Ljudevit Jurak Pathology Department, University Clinical Hospital "Sestre milosrdnice", Pathology Department, School of Dental Medicine, University of Zagreb, Croatia
| | | | - Kiril Trpkov
- Department of Pathology and Laboratory Medicine, Calgary Laboratory Services and University of Calgary, Calgary, AB, Canada
| | - Gao Yuan
- Department of Pathology and Laboratory Medicine, Calgary Laboratory Services and University of Calgary, Calgary, AB, Canada
| | - Petr Grossmann
- Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic
| | - Maris Sperga
- Department of Pathology, University of Split, Croatia
| | - Ivan Ferak
- Department of Pathology, AGEL, Novy Jicin, Czech Republic
| | - Joanna Rogala
- Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic
| | - Jana Mareckova
- Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic
| | - Tomas Pitra
- Department of Urology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic
| | - Jiri Kolar
- Department of Urology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic
| | - Michal Michal
- Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic
| | - Ondrej Hes
- Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic.
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Ohashi R, Martignoni G, Hartmann A, Caliò A, Segala D, Stöhr C, Wach S, Erlmeier F, Weichert W, Autenrieth M, Schraml P, Rupp NJ, Ohe C, Otsuki Y, Kawasaki T, Kobayashi H, Kobayashi K, Miyazaki T, Shibuya H, Usuda H, Umezu H, Fujishima F, Furusato B, Osakabe M, Sugai T, Kuroda N, Tsuzuki T, Nagashima Y, Ajioka Y, Moch H. Multi-institutional re-evaluation of prognostic factors in chromophobe renal cell carcinoma: proposal of a novel two-tiered grading scheme. Virchows Arch 2020; 476:409-18. [PMID: 31760491 DOI: 10.1007/s00428-019-02710-w] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 10/10/2019] [Accepted: 10/25/2019] [Indexed: 12/20/2022]
Abstract
A histological grading system of chromophobe renal cell carcinoma (chRCC) is highly desirable to identify approximately 5-10% of tumors at risk for progression. Validation studies failed to demonstrate a correlation between the four-tiered WHO/ISUP grade and outcome. Previous proposals with three-tiered chromophobe grading systems could not be validated. In this study, the presence of sarcomatoid differentiation, necrosis, and mitosis was analyzed in a Swiss cohort (n = 42), an Italian cohort (n = 103), a German cohort (n = 54), a Japanese cohort (n = 119), and The Cancer Genome Atlas cohort (n = 64). All 3 histological parameters were significantly associated with shorter time to tumor progression and overall survival in univariate analysis. Interobserver variability for identification of these parameters was measured by Krippendorff's alpha coefficient and showed high concordance for the identification of sarcomatoid differentiation and tumor necrosis, but only low to medium concordance for the identification of mitosis. Therefore, we tested a two-tiered tumor grading system (low versus high grade) based only on the presence of sarcomatoid differentiation and/or necrosis finding in the combined cohorts (n = 382). pT stage, patient's age (> 65 vs ≤ 65), lymph node and/or distant metastasis, and the two-tiered grading system (low versus high grade) were significantly associated with overall survival and were independent prognostic parameters in multivariate analysis (Cox proportional hazard). This multi-institutional evaluation of prognostic parameters suggests tumor necrosis and sarcomatoid differentiation as reproducible components of a two-tiered chromophobe tumor grading system.
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Jouini R, Saidi A, Khanchel F, Helal I, Chtourou M, Chadli-Debbiche A. Sarcomatoid chromophobe renal cell carcinoma revealed by acute pyelonephritis in a diabetic patient. Urol Case Rep 2019; 28:101037. [PMID: 31681535 PMCID: PMC6818138 DOI: 10.1016/j.eucr.2019.101037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/05/2019] [Accepted: 10/08/2019] [Indexed: 11/24/2022] Open
Abstract
Chromophobe renal cell carcinoma (CRCC) is a rare tumor comprising 2 types of cells (eosinophilic and clear cells), coexisting in varying proportions. CRCC has an overall good prognosis. However, the rarely encountered sarcomatoid differentiation is associated with a pejorative outcome and must, therefore, be rigorously ruled out. Acute pyelonephritis and other infectious complications rarely occur. We report a case of CRCC with sarcomatoid differentiation in a woman in her sixties which was revealed by acute pyelonephritis and had a lethal outcome.
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Affiliation(s)
- Raja Jouini
- Department of Pathology, Habib Thameur Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia, 8, Ali Ben Ayed Street, 1008, Tunis, Tunisia
| | - Ayoub Saidi
- Department of Pathology, Habib Thameur Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia, 8, Ali Ben Ayed Street, 1008, Tunis, Tunisia
| | - Fatma Khanchel
- Department of Pathology, Habib Thameur Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia, 8, Ali Ben Ayed Street, 1008, Tunis, Tunisia
| | - Imen Helal
- Department of Pathology, Habib Thameur Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia, 8, Ali Ben Ayed Street, 1008, Tunis, Tunisia
| | - Maher Chtourou
- Department of Urology, Habib Thameur Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia, 8, Ali Ben Ayed Street, 1008, Tunis, Tunisia
| | - Aschraf Chadli-Debbiche
- Department of Pathology, Habib Thameur Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia, 8, Ali Ben Ayed Street, 1008, Tunis, Tunisia
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Jorge S, Pereira K, López-Fernández H, LaFramboise W, Dhir R, Fernández-Lodeiro J, Lodeiro C, Santos HM, Capelo-Martínez JL. Ultrasonic-assisted extraction and digestion of proteins from solid biopsies followed by peptide sequential extraction hyphenated to MALDI-based profiling holds the promise of distinguishing renal oncocytoma from chromophobe renal cell carcinoma. Talanta 2019; 206:120180. [PMID: 31514886 DOI: 10.1016/j.talanta.2019.120180] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 07/22/2019] [Accepted: 07/24/2019] [Indexed: 12/12/2022]
Abstract
A novel analytical approach is proposed to discriminate between solid biopsies of chromophobe renal cell carcinoma (chRCC) and renal oncocytoma (RO). The method comprises the following steps: (i) ultrasonic extraction of proteins from solid biopsies, (ii) protein depletion with acetonitrile, (iii) ultrasonic assisted in-solution digestion using magnetic nanoparticle with immobilized trypsin, (iv) C18 tip-based preconcentration of peptides, (v) sequential extraction of the peptides with ACN, (vi) MALDI-snapshot of the extracts and (vii) investigation of the extract containing the most discriminating features using high resolution mass spectrometry. With this approach we have been able to differentially cluster renal oncocytoma and chromophobe renal cell carcinoma and identified 18 proteins specific to chromophobe and seven unique to renal oncocytoma. Chromophobes express proteins associated with ATP function (ATP5I & 5E; VATE1 & G2; ADT2), glycolysis (PGK1) and neuromedin whilst oncocytomas express ATP5H, ATPA, DEPD7 and TRIPB thyroid receptor interacting protein.
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Affiliation(s)
- Susana Jorge
- LAQV, REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal; PROTEOMASS Scientific Society, Madan Park, Rua dos Inventores, 2825-152, Caparica, Portugal
| | - Kevin Pereira
- PROTEOMASS Scientific Society, Madan Park, Rua dos Inventores, 2825-152, Caparica, Portugal
| | - Hugo López-Fernández
- ESEI -Escuela Superior de Ingeniería Informática, Edificio Politécnico, Campus Universitario As Lagoas s/n, Universidad de Vigo, 32004, Ourense, Spain; CINBIO -Centro de Investigaciones Biomédicas, University of Vigo, Campus Universitario Lagoas-Marcosende, 36310, Vigo, Spain; SING Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Hospital Álvaro Cunqueiro, 36312, Vigo, Spain; Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal; Instituto de Biologia Molecular e Celular (IBMC), Rúa Alfredo Allen, 208, 4200-135, Porto, Portugal
| | - William LaFramboise
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Rajiv Dhir
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Javier Fernández-Lodeiro
- LAQV, REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal; PROTEOMASS Scientific Society, Madan Park, Rua dos Inventores, 2825-152, Caparica, Portugal
| | - Carlos Lodeiro
- LAQV, REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal; PROTEOMASS Scientific Society, Madan Park, Rua dos Inventores, 2825-152, Caparica, Portugal
| | - Hugo M Santos
- LAQV, REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal; PROTEOMASS Scientific Society, Madan Park, Rua dos Inventores, 2825-152, Caparica, Portugal
| | - Jose L Capelo-Martínez
- LAQV, REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal; PROTEOMASS Scientific Society, Madan Park, Rua dos Inventores, 2825-152, Caparica, Portugal.
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Ayari Y, Ben Rhouma S, Boussaffa H, Chelly B, Hamza K, Sellami A, Jrad M, Nouira Y. Metachronous isolated locally advanced pancreatic metastasis from chromophobe renal cell carcinoma. Int J Surg Case Rep 2019; 60:196-199. [PMID: 31233964 PMCID: PMC6597480 DOI: 10.1016/j.ijscr.2019.05.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/15/2019] [Accepted: 05/21/2019] [Indexed: 11/26/2022] Open
Abstract
Isolated pancreatic metastasis from renal cell carcinoma is relatively rare and it's usually seen in clear cell renal cell carcinoma (CCRCC), but its occurrence from chromophobe renal cell carcinoma is extremely rare. Pancreatic location is often diagnosed during routine surveillance imaging for the primary lesion. Patients in whom the pancreas is the only metastatic site and who are fit enough to undergo pancreatic surgery appear to be good candidates for the surgical treatment chemotherapy can improve the quality of life but not survival. It is necessary a long- term follow-up for patients treated for tumors with known low-grade metastatic potential and relatively good prognosis such as chromophobe renal cell carcinoma.
Introduction Metastasis to the pancreas is relatively uncommon occurrence. Isolated pancreatic metastasis from renal cell carcinoma (RCC) is relatively rare and it’s usually seen in clear cell renal cell carcinoma (CCRCC), but its occurrence from chromophobe renal cell carcinoma (chRCC) is extremely rare, due to its relatively low-grade metastatic potential. Presentation of case The authors report an unusual case of metachronous isolated pancreatic metastasis, in a 65-year-old female patient two years after left nephrectomy for chRCC, diagnosed during routine surveillance imaging and confirmed after a CT-guided pancreatic biopsy. Discussion The pancreas is an elective site for metastases from RCC, and this particularity has been reported by several studies, but only described for CCRCC. In the English literature there is only one case of pancreatic metastasis from chRCC diagnosed in an autopsy study. Surgical resection of metastasis remains the most effective treatment, particularly for pancreatic metastases from chRCC, since radiotherapy, chemotherapy, hormonal therapy, and targeted therapy have generally proved ineffective for metastatic chRCC. In case of an unresectable disease, surgical or endoscopic palliation in association with palliative chemotherapy can improve the quality of life but not survival. Conclusion This case highlights the unique behavior of chRCC with an unusual site of metastasis, and the necessity of long-term follow-up after primary tumor removal, even if it is known for a low-grade metastatic potential and a relatively good prognosis.
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Affiliation(s)
- Y Ayari
- Department of Urology, La Rabta University Hospital, Tunis, Tunisia.
| | - S Ben Rhouma
- Department of Urology, La Rabta University Hospital, Tunis, Tunisia
| | - H Boussaffa
- Department of Urology, La Rabta University Hospital, Tunis, Tunisia
| | - B Chelly
- Department of Anatomopathology, La Rabta University Hospital, Tunis, Tunisia
| | - K Hamza
- Department of Anatomopathology, La Rabta University Hospital, Tunis, Tunisia
| | - A Sellami
- Department of Urology, La Rabta University Hospital, Tunis, Tunisia
| | - M Jrad
- Department of Radiology, La Rabta University Hospital, Tunis, Tunisia
| | - Y Nouira
- Department of Urology, La Rabta University Hospital, Tunis, Tunisia
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Lin TF, Lin WR, Chen M, Dai SH, Sun FJ, Tsai WK, Chiu AW. Compare Fuhrman Nuclear and Chromophobe Tumor Grade on Chromophobe RCC. Open Med (Wars) 2019; 14:336-342. [PMID: 31032425 PMCID: PMC6475770 DOI: 10.1515/med-2019-0032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/25/2019] [Indexed: 11/26/2022] Open
Abstract
Background Chromophobe renal cell carcinoma (chRCC) has a favorable prognosis. Due to irregular nuclei and nuclear pleomorphism, chRCC has a high Fuhrman nuclear grade (FNG). The chromophobe tumor grade (CTG) is a novel three-tier grading system that has been reported to be a better prognosticator than the traditional FNG. We compared the two nuclear grading systems in terms of patients’ clinical outcomes. Patients and Method We performed this retrospective chart review of all patients with chRCC from 2000 to 2017. All pathologic features and CTG and FNG results were re-evaluated. Result Eighteen patients’ records were reviewed with a mean follow-up of 70.6 months. The nuclear grading distribution was as follows: FNG 2, 56%; FNG 3, 39%; FNG 4, 5%; CTG 1, 78%; CTG 2, 17%; and CTG 3, 6%. Only one patient died. This patient had adrenal invasion, lung metastasis, sarcomatoid change and tumor necrosis, and the tumor was graded as FNG 4 and CTG 3. Overall survival was associated with both FNG and CTG. Conclusion Chromophobe RCC was associated with a low rate of cancer-specific death and sarcomatoid differentiation. Both FNG and CTG were associated with overall survival.
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Affiliation(s)
- Tsu-Feng Lin
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wun-Rong Lin
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan.,Mackay Medical College, Taipei, Taiwan
| | - Marcelo Chen
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan.,Mackay Medical College, Taipei, Taiwan
| | - Shuen-Han Dai
- Department of Pathology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Fang-Ju Sun
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.,MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Wei-Kung Tsai
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan.,Mackay Medical College, Taipei, Taiwan
| | - Allen W Chiu
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan.,Mackay Medical College, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
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46
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Gutiérrez Olivares VM, González Torres LM, Hunter Cuartas G, Niebles De la Hoz MC. [Immunohistochemical profile of renal cell tumours]. Rev Esp Patol 2019; 52:214-221. [PMID: 31530404 DOI: 10.1016/j.patol.2019.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 02/16/2019] [Accepted: 02/21/2019] [Indexed: 10/27/2022]
Abstract
CONTEXT Kidney cancer is among the 10 most frequent cancers in the world, each year about 270,000 cases are diagnosed and 116,000 people die from the disease. Approximately 90% of all solid kidney neoplasms are renal cell carcinomas. The incidence in Colombia is approximately 500-1000 cases per year. OBJECTIVE To characterize through the use of immunohistochemical markers the different renal cell tumours diagnosed in the pathology laboratory of the San José Hospital (HSJ) and the University Infantil Hospital of San José (HUISJ) in Bogotá. MATERIALS AND METHODS A retrospective review was performed of the Hematoxylin and eosin and immunohistochemistry slides of all renal cell carcinomas diagnosed in women and men over 18 years in the pathology laboratory of the HSJ and the HUISJ from Bogotá from January 2014 to December 2016. The antibodies used were: CAIX (carbonic anhydrase), RCC (renal cell carcinoma marker), vimentin, CD10, CK7, TFE3 (transcription factor binding to IGHM enhancer 3), CD117, CD15, CK20, cadherin and PAX8. Absolute and relative frequencies of the different markers were reported through univariate and bivariate analyses with a chi-square test. RESULTS Comparing the expression of statistically significant markers, an immunoprofile resulted for clear cell carcinoma (CRCC) versus RCC chromophobe (ChRCC) as follows: CRCC positive markers: CAIX, vimentin, CD15, CD10, cadherin and negative markers: CK7, CD117; ChRCC positive markers: CK7, CD117, CD10, cadherin and CAIX negative markers: vimentin, CD15. The PAX8 marker was positive or negative in both tumors. CONCLUSION Five markers demonstrated utility and validity to differentiate between histological subtypes of CRCC and ChRCC. We propose the combination of markers (CAIX, CK7, vimentin, CD15 and CD117) for the differential diagnosis between CRCC versus ChRCC.
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Affiliation(s)
| | - Luz Mery González Torres
- Laboratorio de Patología, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia
| | - Guillermo Hunter Cuartas
- Laboratorio de Patología, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia
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Gharbi M, Chakroun M, Chaker K, Zaghbib S, Saadi A, Bouzouita A, Blel A, Aloui R, Ayed H, Cherif M, Ben Slama MR, Rammeh S, Derouiche A, Chebil M. Renal cell carcinoma in an ectopic pelvic kidney: About a case report. Urol Case Rep 2018; 23:46-47. [PMID: 30581753 PMCID: PMC6301969 DOI: 10.1016/j.eucr.2018.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 12/10/2018] [Indexed: 11/18/2022] Open
Affiliation(s)
- Maroua Gharbi
- Department of Urology, Charles Nicolle Hospital, Tunis, India
- Corresponding author.
| | | | - Kays Chaker
- Department of Urology, Charles Nicolle Hospital, Tunis, India
| | - Selim Zaghbib
- Department of Urology, Charles Nicolle Hospital, Tunis, India
| | - Ahmed Saadi
- Department of Urology, Charles Nicolle Hospital, Tunis, India
| | | | - Ahlem Blel
- Department of Pathology, Charles Nicolle Hospital, Tunis, India
| | - Raoudha Aloui
- Department of Pathology, Charles Nicolle Hospital, Tunis, India
| | - Haroun Ayed
- Department of Urology, Charles Nicolle Hospital, Tunis, India
| | - Mohamed Cherif
- Department of Urology, Charles Nicolle Hospital, Tunis, India
| | | | - Soumaya Rammeh
- Department of Pathology, Charles Nicolle Hospital, Tunis, India
| | - Amine Derouiche
- Department of Urology, Charles Nicolle Hospital, Tunis, India
| | - Mohamed Chebil
- Department of Urology, Charles Nicolle Hospital, Tunis, India
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Yin X, Wang J, Zhang J. Identification of biomarkers of chromophobe renal cell carcinoma by weighted gene co-expression network analysis. Cancer Cell Int 2018; 18:206. [PMID: 30564062 PMCID: PMC6296159 DOI: 10.1186/s12935-018-0703-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 12/07/2018] [Indexed: 01/10/2023] Open
Abstract
Background Chromophobe renal cell carcinoma (ChRCC) is the second common subtype of non-clear cell renal cell carcinoma (nccRCC), which accounting for 4–5% of renal cell carcinoma (RCC). However, there is no effective bio-marker to predict clinical outcomes of this malignant disease. Bioinformatic methods may provide a feasible potential to solve this problem. Methods In this study, differentially expressed genes (DEGs) of ChRCC samples on The Cancer Genome Atlas database were filtered out to construct co-expression modules by weighted gene co-expression network analysis and the key module were identified by calculating module-trait correlations. Functional analysis was performed on the key module and candidate hub genes were screened out by co-expression and MCODE analysis. Afterwards, real hub genes were filter out in an independent dataset GSE15641 and validated by survival analysis. Results Overall 2215 DEGs were screened out to construct eight co-expression modules. Brown module was identified as the key module for the highest correlations with pathologic stage, neoplasm status and survival status. 29 candidate hub genes were identified. GO and KEGG analysis demonstrated most candidate genes were enriched in mitotic cell cycle. Three real hub genes (SKA1, ERCC6L, GTSE-1) were selected out after mapping candidate genes to GSE15641 and two of them (SKA1, ERCC6L) were significantly related to overall survivals of ChRCC patients. Conclusions In summary, our findings identified molecular markers correlated with progression and prognosis of ChRCC, which might provide new implications for improving risk evaluation, therapeutic intervention, and prognosis prediction in ChRCC patients. Electronic supplementary material The online version of this article (10.1186/s12935-018-0703-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiaomao Yin
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dong Fang Road, Shanghai, 200127 China
| | - Jianfeng Wang
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dong Fang Road, Shanghai, 200127 China
| | - Jin Zhang
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dong Fang Road, Shanghai, 200127 China
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He H, Trpkov K, Martinek P, Isikci OT, Maggi-Galuzzi C, Alaghehbandan R, Gill AJ, Tretiakova M, Lopez JI, Williamson SR, Montiel DP, Sperga M, Comperat E, Brimo F, Yilmaz A, Pivovarcikova K, Michalova K, Slouka D, Prochazkova K, Hora M, Bonert M, Michal M, Hes O. "High-grade oncocytic renal tumor": morphologic, immunohistochemical, and molecular genetic study of 14 cases. Virchows Arch 2018; 473:725-738. [PMID: 30232607 DOI: 10.1007/s00428-018-2456-4] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/29/2018] [Accepted: 09/10/2018] [Indexed: 12/20/2022]
Abstract
The spectrum of the renal oncocytic tumors has been expanded in recent years to include several novel and emerging entities. We describe a cohort of novel, hitherto unrecognized and morphologically distinct high-grade oncocytic tumors (HOT), currently diagnosed as "unclassified" in the WHO classification. We identified 14 HOT by searching multiple institutional archives. Morphologic, immunohistochemical (IHC), molecular genetic, and molecular karyotyping studies were performed to investigate these tumors. The patients included 3 men and 11 women, with age range from 25 to 73 years (median 50, mean 49 years). Tumor size ranged from 1.5 to 7.0 cm in the greatest dimension (median 3, mean 3.4 cm). The tumors were all pT1 stage. Microscopically, they showed nested to solid growth, and focal tubulocystic architecture. The neoplastic cells were uniform with voluminous oncocytic cytoplasm. Prominent intracytoplasmic vacuoles were frequently seen, but no irregular (raisinoid) nuclei or perinuclear halos were present. All tumors demonstrated prominent nucleoli (WHO/ISUP grade 3 equivalent). Nine of 14 cases were positive for CD117 and cytokeratin (CK) 7 was either negative or only focally positive in of 6/14 cases. All tumors were positive for AE1-AE3, CK18, PAX 8, antimitochondrial antigen, and SDHB. Cathepsin K was positive in 13/14 cases and CD10 was positive in 12/13 cases. All cases were negative for TFE3, HMB45, Melan-A. No TFEB and TFE3 genes rearrangement was found in analyzable cases. By array CGH, complete chromosomal losses or gains were not found in any of the cases, and 3/9 cases showed absence of any abnormalities. Chromosomal losses were detected on chromosome 19 (4/9), 3 with losses of the short arm (p) and 1 with losses of both arms (p and q). Loss of chromosome 1 was found in 3/9 cases; gain of 5q was found in 1/9 cases. On molecular karyotyping, 3/3 evaluated cases showed loss of heterozygosity (LOH) on 16p11.2-11.1 and 2/3 cases showed LOH at 7q31.31. Copy number (CN) losses were found at 7q11.21 (3/3), Xp11.21 (3/3), Xp11.22-11.21 (3/3), and Xq24-25 (2/3). CN gains were found at 13q34 (2/3). Ten patients with available follow up information were alive and without disease progression, after a mean follow-up of 28 months (1 to 112 months). HOT is a tumor with unique morphology and its IHC profile appears mostly consistent. HOT should be considered as an emerging renal entity because it does not meet the diagnostic criteria for other recognized eosinophilic renal tumors, such as oncocytoma, chromophobe renal cell carcinoma (RCC), TFE3 and TFEB RCC, SDH-deficient RCC, and eosinophilic solid and cystic RCC.
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Affiliation(s)
- Huiying He
- Department of Pathology, Health Science Center, Peking University, Beijing, China
| | - Kiril Trpkov
- Department of Pathology and Laboratory Medicine, Calgary Laboratory Services and University of Calgary, Calgary, AB, Canada
| | - Petr Martinek
- Department of Pathology, Medical Faculty and Charles University Hospital Plzen, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Ozlem Tanas Isikci
- Department of Pathology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Cristina Maggi-Galuzzi
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Reza Alaghehbandan
- Department of Pathology, Faculty of Medicine, University of British Columbia, Royal Columbian Hospital, Vancouver, BC, Canada
| | - Anthony J Gill
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.,University of Sydney, Sydney, NSW, 2006, Australia.,NSW Health Pathology Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Maria Tretiakova
- Department of Anatomic Pathology, Harborview Medical Center, Seattle, WA, USA
| | - Jose Ignacio Lopez
- BioCruces Institute, Cruces University Hospital, University of the Basque Country (UPV/EHU), Barakaldo, Bizkaia, Spain
| | | | - Delia Perez Montiel
- Department of Pathology, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Maris Sperga
- Department of Pathology, Riga Stradin's University, Riga, Latvia
| | - Eva Comperat
- Sorbonne Université Service d'Anatomie et Cytologie Pathologiques Hôpital Tenon, HUEP, Paris, France
| | - Fadi Brimo
- Department of Pathology, McGill University, Montreal, QC, Canada
| | - Ali Yilmaz
- Department of Pathology and Laboratory Medicine, Calgary Laboratory Services and University of Calgary, Calgary, AB, Canada
| | - Kristyna Pivovarcikova
- Department of Pathology, Medical Faculty and Charles University Hospital Plzen, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Kveta Michalova
- Department of Pathology, Medical Faculty and Charles University Hospital Plzen, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - David Slouka
- Biomedicine Center, Charles University, Medical Faculty and Charles University Hospital Plzen, Prague, Czech Republic
| | - Kristyna Prochazkova
- Department of Urology, Charles University, Medical Faculty and Charles University Hospital Plzen, Prague, Czech Republic
| | - Milan Hora
- Department of Urology, Charles University, Medical Faculty and Charles University Hospital Plzen, Prague, Czech Republic
| | - Michael Bonert
- Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Michal Michal
- Department of Pathology, Medical Faculty and Charles University Hospital Plzen, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Ondrej Hes
- Department of Pathology, Medical Faculty and Charles University Hospital Plzen, Alej Svobody 80, 304 60, Pilsen, Czech Republic.
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Banapour P, Asanad K, Jabaji R, Artenstein D, Chien G, Asanad S, Sehgal I, Bakhta Y. Paraneoplastic renal cell carcinoma in the setting of preeclampsia and placental abruption. Urol Case Rep 2018; 19:57-59. [PMID: 29888194 PMCID: PMC5991345 DOI: 10.1016/j.eucr.2018.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 05/08/2018] [Indexed: 11/26/2022] Open
Affiliation(s)
- Pooya Banapour
- Department of Urology, Kaiser Permanente Los Angeles Medical Center, CA, USA
| | - Kian Asanad
- David Geffen School of Medicine at University of California, Los Angeles, USA
| | - Ramzi Jabaji
- Department of Urology, Kaiser Permanente Los Angeles Medical Center, CA, USA
| | - Daniel Artenstein
- Department of Urology, Kaiser Permanente Los Angeles Medical Center, CA, USA
| | - Gary Chien
- Department of Urology, Kaiser Permanente Los Angeles Medical Center, CA, USA
| | - Samuel Asanad
- David Geffen School of Medicine at University of California, Los Angeles, USA
| | - Indu Sehgal
- Department of Pathology, Kaiser Permanente Los Angeles Medical Center, CA, USA
| | - Yekaterina Bakhta
- Department of Obstetrics and Gynecology, Kaiser Permanente Downey Medical Center, CA, USA
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