title: Renal cell carcinoma with areas mimicking renal angiomyoadenomatous tumor/clear cell papillary renal cell carcinoma.
abstract: We present a cohort of 8 renal carcinomas that displayed a variable (5%-95% extent) light microscopic appearance of renal angiomyoadenomatous tumor/clear cell papillary renal cell carcinoma (RAT/CCPRCC) without fulfilling the criteria for these tumors. All but 1 case predominantly (75%-95% extent) showed histopathologic features of conventional clear cell renal cell carcinoma. In 5 of 7 cases with mostly conventional clear renal cell carcinoma (CRCC) morphology, a diagnosis of CRCC was supported by the molecular genetic findings (presence of von Hippel-Lindau tumor suppressor [VHL] mutation and/or VHL promoter methylation and/or loss of heterozygosity [LOH] for 3p). Of the other 2 cases with predominantly characteristic CRCC morphology, 1 tumor did not reveal any VHL mutation, VHL promoter methylation, or LOH for 3p, and both chromosomes 7 and 17 were disomic, whereas the other tumor displayed polysomy for chromosomes 7 and 17 and no VHL mutation, VHL promoter methylation, or LOH for 3p. One tumor was composed primarily (95%) of distinctly RAT/CCPRCC-like morphology, and this tumor harbored a VHL mutation and displayed polysomy for chromosomes 7 and 17. Of the 5 cases with both histomorphologic features and molecular genetic findings of CRCC, we detected significant immunoreactivity for α-methylacyl-CoA racemase in 2 cases and strong diffuse immunopositivity for cytokeratin 7 in 3 cases. Despite the combination of positivity for α-methylacyl-CoA racemase and cytokeratin 7 in 2 cases, there was nothing to suggest of the possibility of a conventional papillary renal cell carcinoma with a predominance of clear cells.
authors: Department of Pathology, National University Health System, Singapore, Singapore.
authors: Fredrik
authors: F
authors: Petersson
authors: Petr
authors: P
authors: Grossmann
authors: Milan
authors: M
authors: Hora
authors: Maris
authors: M
authors: Sperga
authors: Delia Perez
authors: DP
authors: Montiel
authors: Petr
authors: P
authors: Martinek
authors: Maria Evelyn Cortes
authors: ME
authors: Gutierrez
authors: Stela
authors: S
authors: Bulimbasic
authors: Michal
authors: M
authors: Michal
authors: Jindrich
authors: J
authors: Branzovsky
authors: Ondrej
authors: O
authors: Hes
mesh_terms: D000236:Adenoma / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D018229:Angiomyoma / Q000175:diagnosis*; D002291:Carcinoma, Papillary / Q000175:diagnosis*; D002292:Carcinoma, Renal Cell / Q000175:diagnosis*; D002869:Chromosome Aberrations; D002886:Chromosomes, Human, Pair 17; D002897:Chromosomes, Human, Pair 7; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D053552:Keratin-7 / Q000378:metabolism; D007680:Kidney Neoplasms / Q000175:diagnosis*; D019656:Loss of Heterozygosity; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis; D019998:Racemases and Epimerases / Q000378:metabolism; D051794:Von Hippel-Lindau Tumor Suppressor Protein / Q000235:genetics; D006623:von Hippel-Lindau Disease
chemical_list: D053552:Keratin-7; D051794:Von Hippel-Lindau Tumor Suppressor Protein; D019998:Racemases and Epimerases; C108352:alpha-methylacyl-CoA racemase