title: Acquired cystic disease-associated renal cell carcinoma: further characterization of the morphologic and immunopathologic features.
abstract: Acquired cystic disease-associated renal cell carcinoma (ACD-RCC) is a subtype of renal cell carcinoma (RCC) with unique morphologic features found exclusively in the background of end-stage renal disease. We analyzed the clinicopathologic features and immumoreactive profiles of 12 cases of ACD-RCC to further characterize this recently recognized entity. Review of histologic slides was performed in conjunction with immunohistochemical staining directed to the contemporary diagnostic antibodies and the putative target therapy-related markers. Histologically, the tumors showed characteristic inter-or intracellular microlumens and eosinophilic tumor cells. Intratumoral hemosiderin deposition and degenerating foamy tumor cells were consistent findings which were not previously described. Immunohistochemically, all the tumors were positive for alpha-methylacyl-CoA-racemase, CD10, pan-cytokeratin, PTEN (phosphatase and tensin homolog deleted on chromosome 10) and c-met, while negative for carbonic anhydrase-9, CD57, CD68, c-kit, pax-2, platelet-derived growth factor receptor (PDGFR)-α or vascular endothelial growth factor receptor (VEGFR)-2. Heterogenous staining was found for CK7 and kidney-specific cadherin. Positive reaction to c-met suggests its utility as a plausible therapeutic target in ACD-RCC. Thus, we present the unique morphologic and immunopathologic features of ACD-RCC, which may be helpful in both diagnostic and therapeutic aspects.
authors.affiliation: Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Korea.
authors.forename: Soomin
authors.initials: S
authors.lastname: Ahn
authors.forename: Ghee Young
authors.initials: GY
authors.lastname: Kwon
authors.forename: Yong Mee
authors.initials: YM
authors.lastname: Cho
authors.forename: Sun-Young
authors.initials: SY
authors.lastname: Jun
authors.forename: Chan
authors.initials: C
authors.lastname: Choi
authors.forename: Hyun-Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Yong Wook
authors.initials: YW
authors.lastname: Park
authors.forename: Weon Seo
authors.initials: WS
authors.lastname: Park
authors.forename: Jung Won
authors.initials: JW
authors.lastname: Shim
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D002292:Carcinoma, Renal Cell / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007633:Keratins / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D007680:Kidney Neoplasms / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015260:Neprilysin / Q000378:metabolism; D019859:Proto-Oncogene Proteins c-met / Q000378:metabolism; D019998:Racemases and Epimerases / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D007633:Keratins; D019859:Proto-Oncogene Proteins c-met; D015260:Neprilysin; D019998:Racemases and Epimerases; C108352:alpha-methylacyl-CoA racemase