Diagnostic criteria for oncocytic renal neoplasms: a survey of urologic pathologists
Language English Country United States Media print-electronic
Document type Journal Article
PubMed
28315424
DOI
10.1016/j.humpath.2017.03.004
PII: S0046-8177(17)30076-X
Knihovny.cz E-resources
- Keywords
- Chromophobe renal cell carcinoma, Diagnostic criteria, Hybrid tumor, Immunohistochemistry, Oncocytoma, Tumor classification,
- MeSH
- Biopsy MeSH
- Molecular Diagnostic Techniques MeSH
- Diagnosis, Differential MeSH
- Immunohistochemistry MeSH
- Carcinoma, Renal Cell chemistry genetics pathology MeSH
- Keratin-7 analysis MeSH
- Humans MeSH
- Mitotic Index MeSH
- Biomarkers, Tumor analysis genetics MeSH
- Kidney Neoplasms chemistry genetics pathology MeSH
- Adenoma, Oxyphilic chemistry genetics pathology MeSH
- Pathologists * MeSH
- Predictive Value of Tests MeSH
- Prognosis MeSH
- Cell Proliferation MeSH
- Health Care Surveys MeSH
- Urologists * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Keratin-7 MeSH
- KRT7 protein, human MeSH Browser
- Biomarkers, Tumor MeSH
Renal oncocytoma and chromophobe renal cell carcinoma have been long recognized as distinct tumors; however, it remains unknown if uniform diagnostic criteria are used to distinguish these tumor types in practice. A survey was distributed to urologic pathologists regarding oncocytic tumors. Responses were received from 17 of 26 invitees. Histologically, more than 1 mitotic figure was regarded as most worrisome (n=10) or incompatible (n=6) with oncocytoma diagnosis. Interpretation of focal nuclear wrinkling, focal perinuclear clearing, and multinucleation depended on extent and did not necessarily exclude oncocytoma if minor. Staining techniques most commonly used included the following: cytokeratin 7 (94%), KIT (71%), vimentin (65%), colloidal iron (59%), CD10 (53%), and AMACR (41%). Rare cytokeratin 7-positive cells (≤5%) were regarded as most supportive of oncocytoma, although an extent excluding oncocytoma was not universal. Multiple chromosomal losses were most strongly supportive for chromophobe renal cell carcinoma diagnosis (65%). Less certainty was reported for chromosomal gain or a single loss. For tumors with mixed or inconclusive features, many participants use an intermediate diagnostic category (82%) that does not label the tumor as unequivocally benign or malignant, typically "oncocytic neoplasm" or "tumor" with comment. The term "hybrid tumor" was used variably in several scenarios. A slight majority (65%) report outright diagnosis of oncocytoma in needle biopsies. The morphologic, immunohistochemical, and genetic characteristics that define oncocytic renal tumors remain incompletely understood. Further studies correlating genetics, behavior, and histology are needed to define which tumors truly warrant classification as carcinomas for patient counseling and follow-up strategies.
Department of Pathology and Laboratory Medicine Detroit MI 48202 United States
Department of Pathology and Molecular Medicine McMaster University Hamilton Ontario L5M 2N1 Canada
Department of Pathology Memorial Sloan Kettering Cancer Center New York NY 10065 United States
Department of Pathology New York University Medical Center New York NY 10016 United States
Department of Pathology University Hospital Zurich Zurich CH 8091 Switzerland
Department of Pathology University of Michigan School of Medicine Ann Arbor MI 48109 United States
Robert J Tomsich Pathology and Laboratory Medicine Institute Cleveland Clinic Cleveland OH 44195 USA
Vattikutti Urology Institute Henry Ford Health System Detroit MI 48202 USA
References provided by Crossref.org
Acceptance of emerging renal oncocytic neoplasms: a survey of urologic pathologists
