Calcium oxalate deposition in renal cell carcinoma associated with acquired cystic kidney disease: a comprehensive study.
The main complication of acquired cystic kidney disease (ACKD) is frequent development of renal tumors, including renal cell carcinoma (RCC). Intratumoral deposition of calcium oxalate (CaOx) is a distinct feature of ACKD-associated RCCs, but several features of this type of RCC are not known. Features of the 30 end-stage renal disease (ESRD)-associated RCCs identified within a 13-year period, including eight with CaOx deposition, were analyzed. Pathologic and clinical features of CaOx positive (+) and negative (-) RCCs were evaluated and compared. The CaOx+ RCCs showed higher tendency for bilaterality and multifocality. Seven tumors displayed distinctive morphologic features characterized by tumor cells with ill-defined cell membrane, abundant granular eosinophilic cytoplasm, large nuclei, and prominent nucleoli. One tumor was of clear cell type. Regardless of histologic type, all tumors displayed a proximal tubular differentiation. No significant difference was noted for tumors' stage, proliferation, and apoptosis rate between the CaOx+ and CaOx- RCCs. CaOx+ RCCs account for a significant portion of all ESRD-associated RCCs. The majority of these RCCs display a distinctive morphologic profile. Proximal tubular cell differentiation in conjunction with ESRD-mediated high serum level may be pathogenetically important for intratumoral CaOx deposition. These RCCs seems to have a relatively good prognosis.
Sule
Norbert
N
Department of Pathology, Renal Section, Baylor College of Medicine, Houston, TX, USA.
Yakupoglu
Ulkem
U
Shen
Steven S
SS
Krishnan
Bhuvaneswari
B
Yang
Guang
G
Lerner
Seth
S
Sheikh-Hamad
David
D
Truong
Luan D
LD
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D002114:Calcinosis / Q000378:metabolism* / Q000473:pathology; D002129:Calcium Oxalate / Q000378:metabolism*; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D052177:Kidney Diseases, Cystic / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000378:metabolism* / Q000473:pathology; D007680:Kidney Neoplasms / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D014408:Biomarkers, Tumor; D002129:Calcium Oxalate