Article

Sub-typing of renal cell tumours: Contribution of ancillary techniques

Department of Histopathology, Post Graduate Institute of Medical Sciences & Research, Chandigarh, India.
Diagnostic Pathology (Impact Factor: 2.41). 07/2009; 4(1):21. DOI: 10.1186/1746-1596-4-21
Source: PubMed

ABSTRACT Adult renal epithelial neoplasms are a heterogeneous group with varying prognosis and outcome requiring sub-classification.
Cases of renal cell carcinoma (RCC) in a 10 years period were analyzed with regard to the clinical features and histology. Sections were reviewed by four pathologists and the discordant cases were resolved with the help of Hale's colloidal iron stain, vimentin, CK 7, and vinculin immunostains and electron microscopy.
Amongst the total of 278 cases, clear cell renal cell carcinoma was the commonest tumor with 74.8% cases, followed by papillary RCC 12.2%, chromophobe RCC 7.9%, oncocytoma 1.8%, and one case of collecting duct RCC. Eight cases were of sarcomatoid renal cell carcinoma. In 28/278 cases, diagnoses varied amongst the four pathologists and the discordance was resolved by Hale's colloidal iron stain, CK7 immunostain and electron microscopy. Vimentin and vinculin did not contribute much in differentiating subtypes of renal cell carcinomas. Relative incidence of sub-types of RCCs was compared with other series.
To accurately subclassify renal cell carcinomas, simple ancillary techniques would possibly resolve all difficult cases. The relative incidence of sub-types of renal cell carcinoma is relatively consistent the world over. However, in India, RCCs afflict the patients two decades earlier.

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    • "Renal cell carcinoma (RCC) has several subtypes, usually identifiable by H + E stain; in some subtypes, ancillary techniques are beneficial for accurate diagnosis [3]. Interestingly, some RCC express neuroendocrine markers, though their prognostic significance remains unclear [4]. "
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    Diagnostic Pathology 05/2012; 7:58. DOI:10.1186/1746-1596-7-58 · 2.41 Impact Factor
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    • "As the distinction is therapeutically and prognostically critical, objective ancillary markers to help in the histologic differentiation between CIS and dysplasia and reactive atypia are necessary. Importance of special and immunohistochemical stains for correct diagnosis and accurate subclassification of controversial cases in other lesions of urinary tract are also emphasized recently by Jin et al [16] and Pradhan et al [17]. Previous studies have demonstrated the diagnostic utility of separate p53 and CK20 immunohistochemistry (IHC) in assessing neoplasia in bladder biopsies [11]. "
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