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. 2013 Oct;47(5):426-32.
doi: 10.4132/KoreanJPathol.2013.47.5.426. Epub 2013 Oct 25.

Histologic variations and immunohistochemical features of metastatic clear cell renal cell carcinoma

Cheol Lee  1 , Jeong-Whan Park, Ja Hee Suh, Kyung Han Nam, Kyung Chul Moon
Affiliations

Histologic variations and immunohistochemical features of metastatic clear cell renal cell carcinoma

Cheol Lee et al. Korean J Pathol. 2013 Oct.

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.

Keywords: Carcinoma, renal cell; Clear cell; Histology; Immunohistochemistry; Neoplasm metastasis.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Histologic variations of clear cell renal cell carcinomas. Typical clear cell morphology (A), eosinophilic cytoplasm (B), rhabdoid features (C), and sarcomatoid differentiation (D).
Fig. 2
Fig. 2
(A) Primary clear cell renal cell carcinoma composed of typical clear cells with rhabdoid features. (B) Metastatic lesion of a lung mainly composed of tumor cells with unclassifiable morphology. Immunohistochemical staining of a metastatic lesion showing CD10 (C) and vimentin (D) positivity.
See this image and copyright information in PMC

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