title: Contemporary approach to diagnosis and classification of renal cell carcinoma with mixed histologic features.
abstract: Renal cell carcinoma (RCC) is an important contributor to cancer-specific mortality worldwide. Targeted agents that inhibit key subtype-specific signaling pathways have improved survival times and have recently become part of the standard of care for this disease. Accurately diagnosing and classifying RCC on the basis of tumor histology is thus critical. RCC has been traditionally divided into clear-cell and non-clear-cell categories, with papillary RCC forming the most common subtype of non-clear-cell RCC. Renal neoplasms with overlapping histologies, such as tumors with mixed clear-cell and papillary features and hybrid renal oncocytic tumors, are increasingly seen in contemporary practice and present a diagnostic challenge with important therapeutic implications. In this review, we discuss the histologic, immunohisto-chemical, cytogenetic, and clinicopathologic aspects of these differential diagnoses and illustrate how the classification of RCC has evolved to integrate both the tumor's microscopic appearance and its molecular fingerprint.
authors.affiliation: Departments of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. ksircar@mdanderson.org
authors.forename: Kanishka
authors.initials: K
authors.lastname: Sircar
authors.forename: Priya
authors.initials: P
authors.lastname: Rao
authors.forename: Eric
authors.initials: E
authors.lastname: Jonasch
authors.forename: Federico A
authors.initials: FA
authors.lastname: Monzon
authors.forename: Pheroze
authors.initials: P
authors.lastname: Tamboli
mesh_terms: D062005:Biopsy, Large-Core Needle; D002292:Carcinoma, Renal Cell / Q000145:classification / Q000175:diagnosis / Q000235:genetics / Q000473:pathology; D056915:DNA Copy Number Variations; D004273:DNA, Neoplasm / Q000235:genetics; D003937:Diagnosis, Differential; D006801:Humans; D007680:Kidney Neoplasms / Q000145:classification / Q000175:diagnosis / Q000235:genetics / Q000473:pathology
chemical_list: D004273:DNA, Neoplasm