TY - JOUR
T1 - Metanephric adenoma and solid variant of papillary renal cell carcinoma
T2 - Common and distinctive features
AU - Mantoan Padilha, Mariana
AU - Billis, Athanase
AU - Allende, Daniela
AU - Zhou, Ming
AU - Magi-Galluzzi, Cristina
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2013/5
Y1 - 2013/5
N2 - Aims: To evaluate morphological and immunohistochemical (IHC) features helpful in distinguishing metanephric adenoma (MA) from solid papillary renal cell carcinoma (s-PRCC). Methods and results: We present a detailed study of 21 MA and 23 s-PRCC. The two entities exhibited significant similarities, both being well-circumscribed tumours composed of tightly packed small cells arranged in solid sheets or ill-defined tubules, often presenting glomeruloid bodies, psammoma bodies and dystrophic calcification, and showing overlapping immunoreactivity for S100, CD57 and CK7. Conversely, most MA were non-encapsulated, whereas most s-PRCC showed a thick fibrous pseudocapsule; MA cells had scanty cytoplasm and a high nuclear:cytoplasmic ratio in comparison to s-PRCC, where occasional tumour cells showed abundant cytoplasm and high nuclear grade. Polypoid branching fronds were common in MA, but absent in s-PRCC; multifocality and papillary hyperplasia/adenoma were seen only in s-PRCC. MA were positive for WT1 and negative for EMA and alpha-methylacyl-CoA racemase (AMACR); s-PRCC were positive for EMA and AMACR and negative for WT1. Conclusions: Despite overlapping features, careful morphological and architectural evaluation should result in accurate diagnosis of most MA and s-PRCC. In challenging cases, IHC stains for WT1, EMA and AMACR may help in distinguishing these two entities.
AB - Aims: To evaluate morphological and immunohistochemical (IHC) features helpful in distinguishing metanephric adenoma (MA) from solid papillary renal cell carcinoma (s-PRCC). Methods and results: We present a detailed study of 21 MA and 23 s-PRCC. The two entities exhibited significant similarities, both being well-circumscribed tumours composed of tightly packed small cells arranged in solid sheets or ill-defined tubules, often presenting glomeruloid bodies, psammoma bodies and dystrophic calcification, and showing overlapping immunoreactivity for S100, CD57 and CK7. Conversely, most MA were non-encapsulated, whereas most s-PRCC showed a thick fibrous pseudocapsule; MA cells had scanty cytoplasm and a high nuclear:cytoplasmic ratio in comparison to s-PRCC, where occasional tumour cells showed abundant cytoplasm and high nuclear grade. Polypoid branching fronds were common in MA, but absent in s-PRCC; multifocality and papillary hyperplasia/adenoma were seen only in s-PRCC. MA were positive for WT1 and negative for EMA and alpha-methylacyl-CoA racemase (AMACR); s-PRCC were positive for EMA and AMACR and negative for WT1. Conclusions: Despite overlapping features, careful morphological and architectural evaluation should result in accurate diagnosis of most MA and s-PRCC. In challenging cases, IHC stains for WT1, EMA and AMACR may help in distinguishing these two entities.
KW - Differential diagnosis
KW - Immunohistochemistry
KW - Metanephric adenoma
KW - Solid variant of papillary renal cell carcinoma
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U2 - 10.1111/his.12106
DO - 10.1111/his.12106
M3 - Article
C2 - 23551615
AN - SCOPUS:84876804074
SN - 0309-0167
VL - 62
SP - 941
EP - 953
JO - Histopathology
JF - Histopathology
IS - 6
ER -