Eosinophilic, solid, and cystic renal cell carcinoma

Kiril Trpkov, Ondrej Hes, Michael Bonert, Jose I. Lopez, Stephen M. Bonsib, Gabriella Nesi, Eva Comperat, Mathilde Sibony, Daniel M. Berney, Petr Martinek, Stela Bulimbasic, Saul Suster, Ankur Sangoi, Asli Yilmaz, John P. Higgins, Ming Zhou, Anthony J. Gill, Christopher G. Przybycin, Cristina Magi-Galluzzi, Jesse K. Mckenney

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

A unique renal neoplasm characterized by eosinophilic cytoplasm and solid and cystic growth was recently reported in patients with tuberous sclerosis complex (TSC). We searched multiple institutional archives and consult files in an attempt to identify a sporadic counterpart. We identified 16 morphologically identical cases, all in women, without clinical features of TSC. The median age was 57 years (range, 31 to 75 y). Macroscopically, tumors were tan and had a solid and macrocystic (12) or only solid appearance (4). Average tumor size was 50 mm (median, 38.5 mm; range, 15 to 135 mm). Microscopically, the tumors showed solid areas admixed with variably sized macrocysts and microcysts that were lined by cells with a pronounced hobnail arrangement. The cells had voluminous eosinophilic cytoplasm with prominent granular cytoplasmic stippling and round to oval nuclei with prominent nucleoli. Scattered histiocytes and lymphocytes were invariably present. Thirteen of 16 patients were stage pT1; 2 were pT2, and 1 was pT3a. The cells demonstrated a distinct immunoprofile: nuclear PAX8 expression, predominant CK20-positive/CK7-negative phenotype, patchy AMACR staining, but no CD117 reactivity. Thirteen of 14 patients with follow-up were alive and without disease progression after 2 to 138 months (mean: 53 mo; median: 37.5 mo); 1 patient died of other causes. Although similar to a subset of renal cell carcinomas (RCCs) seen in TSC, we propose that sporadic "eosinophilic, solid, and cystic RCC," which occurs predominantly in female individuals and is characterized by distinct morphologic features, predominant CK20-positive/CK7-negative immunophenotype, and indolent behavior, represents a novel subtype of RCC.

Original languageEnglish (US)
Pages (from-to)60-71
Number of pages12
JournalAmerican Journal of Surgical Pathology
Volume40
Issue number1
DOIs
StatePublished - Jan 1 2016

Fingerprint

Renal Cell Carcinoma
Tuberous Sclerosis
Cytoplasm
Neoplasms
Histiocytes
Kidney Neoplasms
Disease Progression
Lymphocytes
Staining and Labeling
Phenotype
Growth

Keywords

  • CK20
  • eosinophilic tumor
  • renal cell carcinoma
  • tuberous sclerosis
  • unclassified oncocytic tumor
  • unclassified renal cell carcinoma

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

Cite this

Trpkov, K., Hes, O., Bonert, M., Lopez, J. I., Bonsib, S. M., Nesi, G., ... Mckenney, J. K. (2016). Eosinophilic, solid, and cystic renal cell carcinoma. American Journal of Surgical Pathology, 40(1), 60-71. https://doi.org/10.1097/PAS.0000000000000508

Eosinophilic, solid, and cystic renal cell carcinoma. / Trpkov, Kiril; Hes, Ondrej; Bonert, Michael; Lopez, Jose I.; Bonsib, Stephen M.; Nesi, Gabriella; Comperat, Eva; Sibony, Mathilde; Berney, Daniel M.; Martinek, Petr; Bulimbasic, Stela; Suster, Saul; Sangoi, Ankur; Yilmaz, Asli; Higgins, John P.; Zhou, Ming; Gill, Anthony J.; Przybycin, Christopher G.; Magi-Galluzzi, Cristina; Mckenney, Jesse K.

In: American Journal of Surgical Pathology, Vol. 40, No. 1, 01.01.2016, p. 60-71.

Research output: Contribution to journalArticle

Trpkov, K, Hes, O, Bonert, M, Lopez, JI, Bonsib, SM, Nesi, G, Comperat, E, Sibony, M, Berney, DM, Martinek, P, Bulimbasic, S, Suster, S, Sangoi, A, Yilmaz, A, Higgins, JP, Zhou, M, Gill, AJ, Przybycin, CG, Magi-Galluzzi, C & Mckenney, JK 2016, 'Eosinophilic, solid, and cystic renal cell carcinoma', American Journal of Surgical Pathology, vol. 40, no. 1, pp. 60-71. https://doi.org/10.1097/PAS.0000000000000508
Trpkov K, Hes O, Bonert M, Lopez JI, Bonsib SM, Nesi G et al. Eosinophilic, solid, and cystic renal cell carcinoma. American Journal of Surgical Pathology. 2016 Jan 1;40(1):60-71. https://doi.org/10.1097/PAS.0000000000000508
Trpkov, Kiril ; Hes, Ondrej ; Bonert, Michael ; Lopez, Jose I. ; Bonsib, Stephen M. ; Nesi, Gabriella ; Comperat, Eva ; Sibony, Mathilde ; Berney, Daniel M. ; Martinek, Petr ; Bulimbasic, Stela ; Suster, Saul ; Sangoi, Ankur ; Yilmaz, Asli ; Higgins, John P. ; Zhou, Ming ; Gill, Anthony J. ; Przybycin, Christopher G. ; Magi-Galluzzi, Cristina ; Mckenney, Jesse K. / Eosinophilic, solid, and cystic renal cell carcinoma. In: American Journal of Surgical Pathology. 2016 ; Vol. 40, No. 1. pp. 60-71.
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