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Diagnostic criteria for oncocytic renal neoplasms: a survey of urologic pathologists.

  • Williamson SR Department of Pathology and Laboratory Medicine, Detroit, MI, 48202, United States; Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, 48202, United States; Department of Pathology, Wayne State University School of Medicine, Detroit, MI, 48202, United States. Electronic address: seanwill@temple.edu.
  • Gadde R Department of Pathology and Laboratory Medicine, Detroit, MI, 48202, United States.
  • Trpkov K Department of Pathology and Laboratory Medicine, Calgary Laboratory Service and University of Calgary, Calgary, Alberta, T2V 1P9, Canada.
  • Hirsch MS Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, United States.
  • Srigley JR Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, L5M 2N1, Canada.
  • Reuter VE Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, United States.
  • Cheng L Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, 46202, United States.
  • Kunju LP Department of Pathology, University of Michigan School of Medicine, Ann Arbor, MI, 48109, United States.
  • Barod R Vattikutti Urology Institute, Henry Ford Health System, Detroit, MI, 48202, USA.
  • Rogers CG Vattikutti Urology Institute, Henry Ford Health System, Detroit, MI, 48202, USA.
  • Delahunt B Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, University of Otago - Wellington, Wellington, 6242, New Zealand.
  • Hes O Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzeň, Pilsen, 304 60, Czech Republic.
  • Eble JN Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, 46202, United States.
  • Zhou M Department of Pathology, New York University Medical Center, New York, NY, 10016, United States.
  • McKenney JK Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
  • Martignoni G Department of Pathology and Diagnostics, University of Verona, Verona, 37134, Italy; Department of Pathology, Pederzoli Hospital, Peschiera del Garda, 37014, Italy.
  • Fleming S Department of Cellular and Molecular Pathology, University of Dundee, Ninewells Hospital, Dundee, DD1 9SY, United Kingdom.
  • Grignon DJ Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, 46202, United States.
  • Moch H Department of Pathology, University Hospital Zurich, Zurich, CH-8091, Switzerland.
  • Gupta NS Department of Pathology and Laboratory Medicine, Detroit, MI, 48202, United States; Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, 48202, United States.
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  • 2017-03-19
Published in:
  • Human pathology. - 2017
Chromophobe renal cell carcinoma
Diagnostic criteria
Hybrid tumor
Immunohistochemistry
Oncocytoma
Tumor classification
Adenoma, Oxyphilic
Biomarkers, Tumor
Biopsy
Carcinoma, Renal Cell
Cell Proliferation
Diagnosis, Differential
Health Care Surveys
Humans
Immunohistochemistry
Keratin-7
Kidney Neoplasms
Mitotic Index
Molecular Diagnostic Techniques
Pathologists
Predictive Value of Tests
Prognosis
Urologists
English 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.
Language
  • English
Open access status
green
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Persistent URL
https://sonar.ch/global/documents/258542
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