Eosinophilic Vacuolated Tumor of the Kidney: A Review of Evolving Concepts in This Novel Subtype with Additional Insights from a Case with MTOR Mutation and Concomitant Chromosome 1 Loss

Payal Kapur, Ming Gao, Hua Zhong, DInesh Rakheja, Qi Cai, Ivan Pedrosa, Vitaly Margulis, Lin Xu, Lisa Kinch, James Brugarolas

Research output: Contribution to journalReview articlepeer-review

Abstract

Recent advances in molecular genetics have expanded our knowledge of renal tumors and enabled a better classification. These studies have revealed that renal tumors with predominantly "eosinophilic/oncocytic" cytoplasm include several novel biological subtypes beyond the traditionally well-recognized renal oncocytoma and an eosinophilic variant of chromophobe renal cell carcinoma. Herein, we present a comprehensive review of the eosinophilic vacuolated tumor (EVT) building upon a case report including radiology, histopathology, electron microscopy, and next-generation sequencing. EVTs are characterized by mTORC1 activation. We speculate that loss of chromosome 1 in EVT with MTOR mutation may be driven in part by an advantage conferred by loss of the remaining MTOR wild-type allele. mTORC1 is best known for its role in promoting protein translation and it is interesting that dilated cisterns of rough endoplasmic reticulum (ER) likely account for the cytoplasmic vacuoles seen by light microscopy. We present an integrated view of EVT as well as cues that can assist in the differential diagnosis.

Original languageEnglish (US)
Pages (from-to)251-257
Number of pages7
JournalAdvances in anatomic pathology
Volume28
Issue number4
DOIs
StatePublished - Jul 2021

Keywords

  • MTOR
  • RCC with cytoplasmic eosinophilia
  • TSC-associated RCC
  • eosinophilic tumor
  • eosinophilic vacuolated tumor
  • eosinophilic variant of chromophobe renal cell carcinoma
  • high-grade oncocytic tumor
  • hybrid oncocytic/chromophobe RCCs
  • unclassified oncocytic tumor

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

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