Urologic Oncology: Seminars and Original Investigations
Original articlesChromophobe renal cell carcinoma showing oncocytoma-like hyalinized and edematous stroma: A case report and review of the literature
Introduction
Chromophobe renal cell carcinoma (CRCC) is an uncommon subtype of renal cell carcinoma first described by Thoenes et al. in 1985 [1]. Although CRCC was initially considered to be rare, its frequency has been reported to range between 2% and 11% of all renal epithelial neoplasms [1], [2], [3], [4]. Although Hale’s colloidal iron stain positivity is considered to be characteristic for CRCC [1], [2], [4], [5], several investigators have shown that other renal tumors also display positive reactions for Hale’s colloidal iron stain with variable intensities [6], [7]. Although CRCC has been reported to have a more favorable prognosis than conventional renal cell carcinoma [1], [3], [4], [5], sarcomatoid transformation has been reported [8], [9]. On the basis of previously described findings, CRCC has been considered as a distinct entity in clinicopathological aspect. However, CRCC may resemble oncocytoma on routine stains, and investigators have encountered difficulty in distinguishing CRCC from oncocytoma histologically. The importance of distinguishing CRCC from oncocytoma is because of the different prognosis. The presence of hyalinized stroma in CRCC has been briefly mentioned [3], [9], however, myxoid areas in CRCC have been uncommon [7], [10]. We describe here a case of CRCC with abundant hyalinized and edematous stroma mimicking oncocytoma.
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Case reports
An 86-yr-old Japanese woman was admitted to our hospital with a complaint of rectal bleeding. Colonic endoscopy showed a centrally ulcerated tumor of the transverse colon. Preoperative examination for colonic tumor incidentally demonstrated a right renal mass on a computerized tomography (CT) scan. Angiography revealed a hypovascular tumor in the right kidney. Colectomy and right radical nephrectomy were performed, and the colectomy specimen showed primary colonic adenocarcinoma.
The surgically
Discussion
The cellular morphology of CRCC, such as nuclear and cytoplasmic findings, has been well described. Detailed study of the histological architecture, especially tumor stroma, has not been performed, although stromal calcification in CRCC has been reported [2], [4], [11]. Myxoid and fibrotic areas in CRCC have been uncommon [7], [10], although hypocellular hyalinized stroma partially showing an oncocytoma-like proliferation pattern in CRCC has been reported [9]. Billis et al. [3] mentioned that 5
References (18)
- et al.
Chromophobe cell renal carcinomaclinicopathological features of 50 cases
J Urol
(1995) - et al.
Human chromophobe cell renal carcinoma
Virchows Arch B Cell Pathol
(1985) - et al.
Chromophobe cell carcinoma of the kidney. A clinicopathologic study of 21 cases
Am J Surg Pathol
(1995) - et al.
Chromophobe renal cell carcinomaclinicopathological study of 7 cases
Ultrastructural Pathol
(1998) - et al.
Chromophobe cell carcinomaanalysis of five cases
Am J Surg Pathol
(1990) - et al.
Chromophobe renal cell carcinoma. A comparative histochemical and immunohistochemical study
J Urol Pathol
(1996) - et al.
Renal chromophobe cell carcinoma and oncocytoma. A comparative morphologic, histochemical, and immunohistochemical study of 124 cases
Arch Pathol Lab Med
(1997) - et al.
Chromophobe renal cell carcinoma with osteosarcoma-like differentiation
Am J Surg Pathol
(2002) - et al.
A case of chromophobe renal cell carcinoma with sarcomatoid foci and a small daughter lesion
Pathol Int
(1998)
Cited by (7)
Hyalinized stroma is a characteristic feature of pancreatic intraductal oncocytic papillary neoplasm: An immunohistochemical study
2020, Annals of Diagnostic PathologyCitation Excerpt :Hyalinized stroma (HS), which is a dense, eosinophilic, and amorphous material, is occasionally observed in the stroma of the papillary structure of IOPN [6]. HS has been observed not only in IOPN, but also in other tumors such as basaloid squamous carcinoma of the upper aerodigestive tract, endometrioid carcinomas of the uterine corpus, myoepithelial tumors of soft tissue, renal oncocytoma, ovarian clear cell carcinoma, and chromophobe renal cell carcinoma [6,8-21]. However, the histopathological features of HS in IPMN and IOPN have not been well documented.
Oncocytic renal cell carcinoma with immunohistochemical properties of renal oncocytoma
2009, Pathology Research and PracticeClaudin-7 and claudin-8: immunohistochemical markers for the differential diagnosis of chromophobe renal cell carcinoma and renal oncocytoma
2009, Human PathologyCitation Excerpt :Chromophobe RCC, in contrast, is a malignant renal epithelial neoplasm that may undergo tumor necrosis, sarcomatoid differentiation, and metastasis like other more common renal cancers [11-15]. However, chromophobe RCC and oncocytoma often show overlapping features, with some cases of chromophobe RCC showing areas with oncocytoma-like hyalinized and edematous stroma or eosinophilic changes [16,17]. The relatively recent description of so-called hybrid tumors, which can be associated with the Birt-Hogg-Dubé syndrome and are composed of both chromophobe RCC, oncocytomas, and/or other renal tumors, complicates the issue of differential diagnosis even more [18-21].
Pathobiology and prognosis of chromophobe renal cell carcinoma
2008, Urologic Oncology: Seminars and Original InvestigationsCitation Excerpt :Recent studies revealed new immunohistochemical markers such as c-kit [9] and cytokeratin 7 [10] as useful tools. As previously stated, another distinguishing feature includes diffuse cytoplasmic reactivity with Hale's colloidal staining, which stains acid mucopolysaccharides within the cytoplasmic microvesicles of the tumor [6,8,18]. However, studies have shown that other sub-types also display positive reactions with variable intensities [6,8,19].
Subtypes of renal cell carcinoma: A chromophobe cell carcinoma
2005, Feuillets de Radiologie