title: Histologic variations and immunohistochemical features of metastatic clear cell renal cell carcinoma.
abstract: BACKGROUND
  Due to advancements in treatment of metastatic and advanced renal cell carcinoma (RCC), it has become increasingly important to diagnose metastatic RCC and the specific subtype. In this study, we investigated the diverse histologic features of metastatic clear cell renal cell carcinoma (CCRCC) cases in comparison with corresponding primary lesions.
  
  
  METHODS
  We identified 119 metastatic CCRCC cases from 81 corresponding primary lesions diagnosed between 1995 and 2010 and evaluated the diverse histologic and immunohistochemical features of these lesions.
  
  
  RESULTS
  A total of 44 primary lesions (54.3%) had a non-clear cell component in addition to a typical clear cell component. Of the 119 metastatic lesions, 63 lesions (52.9%) contained a non-clear cell component, and 29 metastatic lesions were composed of a non-clear cell component only. Rhabdoid features were the most frequent non-clear cell histology among the metastatic lesions. Metastatic CCRCCs mainly showed positive CD10 and epithelial membrane antigen staining and negative cytokeratin 7 staining.
  
  
  CONCLUSIONS
  Metastatic CCRCC commonly showed a variety of histologic features. If there is a difficulty to diagnose metastatic CCRCC due to a variety of histologic features or small biopsy specimen, histologic review of the primary lesion and immunohistochemical analysis can help determine the correct diagnosis.
authors.affiliation: Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Cheol
authors.initials: C
authors.lastname: Lee
authors.forename: Jeong-Whan
authors.initials: JW
authors.lastname: Park
authors.forename: Ja Hee
authors.initials: JH
authors.lastname: Suh
authors.forename: Kyung Han
authors.initials: KH
authors.lastname: Nam
authors.forename: Kyung Chul
authors.initials: KC
authors.lastname: Moon
keywords: Carcinoma, renal cell; Clear cell; Histology; Immunohistochemistry; Neoplasm metastasis