title: Oncocytic papillary renal cell carcinoma: a clinicopathological study emphasizing distinct morphology, extended immunohistochemical profile and cytogenetic features.
abstract: Papillary renal cell carcinoma (PRCC) is traditionally classified into type 1 and type 2. Recently, an oncocytic variant of PRCC has been described. We report a series of 6 oncocytic renal papillary tumors (OPRCC) which tended to occur in older patients (mean, 56.8 years) with a male preference (male-to-female ratio is 5:1). All 6 patients are alive with no evidence of disease after initial resection, showing an indolent clinical behavior. Histologically, tumors exhibited predominant papillary structure with delicate fibrovascular cores. Papillae were lined by single layers of cells with large, deeply eosinophilic and finely granular cytoplasms and round regular nucleus. The phagocytosis of tumor cells was frequently and evidently seen in our cases that hemosiderin-laden tumor cells and foamy tumor cells were noticed in five and four cases respectively. All tumors were immunoreactive for racemase, vimentin, CD10, and MET and negative for CD117. While E-cadherin, EMA, and cytokeratin 7 exhibited variable immunopositivity. FISH analysis was performed in five of six cases and found heterogeneous results. Trisomy of chromosomes 7 was found in three cases and trisomy of chromosomes 17 in two cases. Loss of chromosome Y was noted in one of four tumors in male patients. MET gene status was also investigated by direct sequencing in all 6 cases and found no distinct mutation in any case. These results suggest that OPRCC shows distinct morphology, indolent clinical behavior, and similar immunohistochemical and cytogenetic features with PRCC, seems to be a variant in the PRCC group. Whether the strong expression of MET indicates a potential therapeutic target is still unknown and requires further investigation in clinical trials.
authors.affiliation: Department of Pathology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Qiu-Yuan
authors.initials: QY
authors.lastname: Xia
authors.forename: Qiu
authors.initials: Q
authors.lastname: Rao
authors.forename: Qin
authors.initials: Q
authors.lastname: Shen
authors.forename: Shan-Shan
authors.initials: SS
authors.lastname: Shi
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.forename: Biao
authors.initials: B
authors.lastname: Liu
authors.forename: Jin
authors.initials: J
authors.lastname: Zhang
authors.forename: Yan-Fen
authors.initials: YF
authors.lastname: Wang
authors.forename: Qun-Li
authors.initials: QL
authors.lastname: Shi
authors.forename: Jian-Dong
authors.initials: JD
authors.lastname: Wang
authors.forename: Heng-Hui
authors.initials: HH
authors.lastname: Ma
authors.forename: Zhen-Feng
authors.initials: ZF
authors.lastname: Lu
authors.forename: Bo
authors.initials: B
authors.lastname: Yu
authors.forename: Ru-Song
authors.initials: RS
authors.lastname: Zhang
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Zhou
mesh_terms: D018249:Adenoma, Oxyphilic / Q000737:chemistry / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics; D002292:Carcinoma, Renal Cell / Q000737:chemistry / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D002886:Chromosomes, Human, Pair 17; D002897:Chromosomes, Human, Pair 7; D041322:Chromosomes, Human, Y; D020732:Cytogenetic Analysis; D004252:DNA Mutational Analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D007680:Kidney Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015260:Neprilysin / Q000032:analysis; D011237:Predictive Value of Tests; D019859:Proto-Oncogene Proteins c-met / Q000032:analysis / Q000235:genetics; D019998:Racemases and Epimerases / Q000032:analysis; D014314:Trisomy; D014746:Vimentin / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D014746:Vimentin; C491743:MET protein, human; D019859:Proto-Oncogene Proteins c-met; D015260:Neprilysin; D019998:Racemases and Epimerases
keywords: Kidney; MET; oncocytic tumors; papillary renal cell carcinoma