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: 2.6). 07/2009; 4(1):21. DOI: 10.1186/1746-1596-4-21
Source: PubMed


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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