HISTOLOGICAL FEATURES OF CHROMOPHOBE RENAL CELL CARCINOMA
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Keywords

chromophobe renal cell carcinoma, differential diagnostics, immunohistochemical method, eosinophilic renal neoplasms

How to Cite

V. V. Baranovska, A. M. Romanenko, & L. M. Zakhartseva. (2020). HISTOLOGICAL FEATURES OF CHROMOPHOBE RENAL CELL CARCINOMA. Eastern Ukrainian Medical Journal, 8(1), 15-23. https://doi.org/10.21272/eumj.2020;8(1):15-23

Abstract

Introduction. Renal neoplasms are a common disease. Differential diagnostics of different tumor subtypes for prognosis and treatment is necessary given that some of them, like renal cell oncocytomas, are benign, and others, like chromophobe renal cell carcinomas, are malignant. Unfortunately, the histological similarity between these tumors makes accurate diagnostics difficult. In some cases, additional diagnostic methods such as immunohistochemistry should be used. The aim of our study is to analyze the histological characteristics of chromophobe renal cell carcinomas and renal oncocytomas, in order to specify their pathognomonic features, allowing for the confirmation of the diagnosis.

Materials and methods. We used data from histories of disease and histological postoperative material of 198 patients with chromophobe renal cell carcinoma and renal oncocytoma. After the diagnosis was confirmed, we described the histological features of the tumors and calculated their relative prevalence amongst the renal oncocytoma and chromophobe renal cell carcinoma tissues. To conclude, we identified the histological features that are more likely to be present in the case of chromophobe renal cell carcinoma.

Conclusions. Chromophobe renal cell carcinomas are present in 31 % of our samples. Tumors are more prevalent in patients in their sixth and seventh decade. Most chromophobe renal cell carcinomas are unilateral.

Chromophobe renal cell carcinomas have a polymorphic histological structure. The classic variant of chromophobe renal cell carcinoma is more common than the eosinophilic one. A mixed variant of chromophobe renal cell carcinoma is present in a minority of cases. The most common features of ChRCC are solid and alveolar growth patterns, clear and reticular cytoplasm, raisinoid nuclei.

After comparing the relative prevalence of various histological features in renal oncocytomas to those present in chromophobe renal cell carcinomas, we are able to ascertain that chromophobe renal cell carcinomas tend to exhibit the following features significantly more often than renal oncocytomas: differing nuclear size, raisinoid nuclei, reticular cytoplasm, clear cytoplasm.

The particular features mentioned in the preceding paragraph, can be present on a small subset of the tumor tissue, and are thus, often missed during analysis, which can lead to misdiagnosis. In order to mitigate this risk, we recommend analyzing a big sample of tumor tissue and using additive methods such as immunohistochemistry with biomarkers CD 10 (56C6), CD 68 (KP1), Cytokeratin 7 (OV-TL 12/30), CD117/c-kit, Vimentin (Vim3B4), S-100 (4C4.9).

https://doi.org/10.21272/eumj.2020;8(1):15-23
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References

1. Fedorenko ZP, Michailovich YY, Goulak LO, Gorokh YL, Ryzhov AY, Soumkina OV, Koutsenko LB. [BULLETIN OF NATIONAL CANCER REGISTRY OF UKRAINE KYIV - 2019]
2. Shapiro DD, Abel EJ. (2018). [Predicting aggressive behavior in small renal tumors prior to treatment]. Annals of translational medicine, 6 (Suppl 2). doi: 10.21037/atm.2018.12.46
3. Tomaszewski JJ, Uzzo RG, Smaldone MC. (2014). [Heterogeneity and renal mass biopsy: a review of its role and reliability]. Cancer biology & medicine, 11(3), 162. doi: 10.7497/j.issn.2095-3941.2014.03.002
4. Ng KL, Rajandram R, Morais C, Yap NY, Samaratunga H, Gobe GC, Wood ST. (2014). [Differentiation of oncocytoma from chromophobe renal cell carcinoma (RCC): can novel molecular biomarkers help solve an old problem?]. Journal of Clinical Pathology, 67(2), 97-104. doi: 10.1136/jclinpath-2013-201895
5. Badowska-Kozakiewicz AM, Budzik MP, Koczkodaj P, Przybylski J. (2016). [Selected tumor markers in the routine diagnosis of chromophobe renal cell carcinoma]. Archives of medical science: AMS, 12(4), 856. doi: 10.5114/aoms.2015.51188
6. Moch, H, Cubilla AL, Humphrey PA, Reuter VE, Ulbright TM. (2016). [The 2016 WHO classification of tumours of the urinary system and male genital organs—part A: renal, penile, and testicular tumours]. European urology, 70(1), 93-105. doi: 10.1016/j.eururo.2016.02.029
7. Peyromaure M, Misrai V, Thiounn N, Vieillefond A, Zerbib M, Flam TA, Debré B. (2004). [Chromophobe renal cell carcinoma: analysis of 61 cases]. Cancer: Interdisciplinary International Journal of the American Cancer Society, 100(7), 1406-1410.
8. Kim SS, Choi YD, Shim MK, Kim J, Cho YM, Jang JJ, Choi C. (2012). [Microscopic and nuclear morphometric findings of chromophobe renal cell carcinoma, renal oncocytoma, and tumor with overlapping histology]. Annals of diagnostic pathology, 16(6), 429-435. doi: 10.1016/j.anndiagpath.2012.03.002
9. Zimpfer A, Janke S, Hühns M, Schneider B, Kundt G, Zettl H, Erbersdobler A. (2014). [C-kit overexpression is not associated with KIT gene mutations in chromophobe renal cell carcinoma or renal oncocytoma]. Pathology-Research and Practice, 210(8), 521-525. doi: 10.1016/j.prp.2014.04.013
10. Ren W, Xue B, Qu J, Liu L, Li C, Zu X. (2018). [Localized chromophobe renal cell carcinoma: preoperative imaging judgment and laparoscopic simple enucleation for treatment]. International braz j urol, 44(5), 922-932. doi: 10.1590/S1677-5538.IBJU.2017.0519
11. Din NU, Fatima S, Ahmad Z. (2013). [Chromophobe renal cell carcinoma: a morphologic and immunohistochemical study of 45 cases]. Annals of diagnostic pathology, 17(6), 508-513. doi: 10.1016/j.anndiagpath.2013.06.005.
12. von Brandenstein M, Puetz K, Schlosser M, Löser H, Kallinowski JP, Gödde D, Fries JW. (2015). [Vimentin 3, the new hope, differentiating RCC versus oncocytoma]. Disease markers, 2015. doi: 10.1155/2015/368534
13. Foix MP, Dunatov A, Martinek P, Mundó EC, Suster S, Sperga M, Alaghehbandan R. (2016). [Morphological, immunohistochemical, and chromosomal analysis of multicystic chromophobe renal cell carcinoma, an architecturally unusual challenging variant]. Virchows Archiv, 469(6), 669-678. doi: 10.1007/s00428-016-2022-x
14. Lopez-Beltran A, Scarpelli M, Montironi R, Kirkali Z. (2006). [2004 WHO classification of the renal tumors of the adults]. European urology, 49(5), 798-805. doi: 10.1016/j.eururo.2005.11.035
15. Delahunt B, Sika-Paotonu D, Bethwaite PB, McCredie MR, Martignoni G, Eble JN, Jordan TW. (2007). [Fuhrman grading is not appropriate for chromophobe renal cell carcinoma]. The American journal of surgical pathology, 31(6), 957-960. doi: 10.1097/01.pas.0000249446.28713.53
16. Finley DS, Shuch B, Said JW, Galliano G, Jeffries RA, Afifi AA, Belldegrun AS. (2011). [The chromophobe tumor grading system is the preferred grading scheme for chromophobe renal cell carcinoma]. The Journal of urology, 186(6), 2168-2174. doi: 10.1016/j.juro.2011.07.068
17. Srigley JR, Delahunt B, Eble JN, Egevad L, Epstein JI, Grignon D, Zhou M. (2013). [The International Society of Urological Pathology (ISUP) vancouver classification of renal neoplasia]. The American journal of surgical pathology, 37(10), 1469-1489. doi: 10.1097/PAS.0b013e318299f2d1
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