Differentiation between Chromophobe Cell Renal Carcinoma and Oncocytoma_West China Medical Journal

Authors：

 CHENLi-bo ¹ , WANGXian-ding ¹ , HURong ² ,  LUYi-ping ¹

1. Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Radiology, the First Affiliated Hospital of Nanhua University, Hengyang, Hunan 421001, P. R. China;

Corresponding author：

LUYi-ping, Email: yipinglu@163.com

Keywords：

Chromophobe cell carcinoma; Oncocytoma; Immunohistochemical staining; Differential diagnosis

DOI：

10.7507/1002-0179.20140151

Video：

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Objective To investigate the clinical features, differential diagnosis and treatment for chromophobe cell renal carcinoma (CRCC) and renal oncocytoma. Methods From December 2009 to May 2013, we selected 41 cases of CRCC and 22 cases of renal oncocytoma, retrospectively analyzed their clinical features, ultrasonography and CT findings and performed immunohistochemical staining for CK7, CD10, PAX-2, and Ksp-cadherin. Results CRCC could be associated with lower back pain or hematuria, and renal oncocytoma generally did not have clinical symptoms. Ultrasonography and CT examination were not specific for the differentiation between the two diseases. The expression rates of CK7, CD10, PAX-2, and Ksp-cadherin in CRCC were 66% (21/32), 22% (7/32), 23% (3/13) and 93% (14/15), respectively. In patients with oncocytoma, 7% (1/15) were positive for CK7, 7% (1/15) were positive for CD10, 86% (13/15) were positive for PAX-2, and 31% (4/13) were positive for Ksp-cadherin. Pearson chi-square analysis was performed with a significant P value set at <0.05. The results of CK7(-)CD10(-)PAX-2(+) and CK7(-)CD10(-)Ksp-cadherin(-) immunohistochemistry were integrated, which also showed the differences. Conclusion The combination of CK7(-)CD10(-)PAX-2(+) and CK7(-)CD10(-)Ksp-cadherin(-) immunohistochemistry may be useful for differentiating between CRCC and oncocytoma. Combined with imaging examination, it can further improve the differential diagnosis of the two diseases.

Citation： CHENLi-bo, WANGXian-ding, HURong, LUYi-ping. Differentiation between Chromophobe Cell Renal Carcinoma and Oncocytoma. West China Medical Journal, 2014, 29(3): 504-507. doi: 10.7507/1002-0179.20140151 Copy

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1. Thoenes W, Stsrkel S, Rumpeh HJ. Human chromophobe cell renal carcinoma[J]. Virchows Arch B Cell Pathol Incl Mol Pathol, 1985, 48(3):207-221.
2. Klein MJ, Valensi QJ. Proximal tubular adenomas of kidney with so-called oncocytic features. A clinicopathologic study of 13 cases of a rarely reported neoplasm[J]. Cancer, 1976, 38(2):906-914.
3. Eble J, Sauter G, Epstein JI, et al. WHO classification of tumors:pathology and genetics of tumours of the urinary system and male genital organs[M]. Lyon:IARC Press, 2004.
4. Rohan S, Tu JJ, Kao J, et al. Gene expression profiling separates chromophobe renal cell carcinoma from oncocytoma and identifies vesicular transport and cell junction proteins as differentially expressed genes[J]. Clin Cancer Res, 2006, 12(23):6937-6945.
5. Eble JN, Sauter G, Epstein JI, et al. Pathology and genetics of tumors of the urinary system and male genital organs[M]. Lyon:LARC Press, 2004:12-76.
6. Rosenkrantz AB, Hindman N, Fitzgerald EF, et al. MRI features of renal oncocytoma and chromophobe renal cell carcinoma[J]. AJR Am J Roentgenol, 2010, 195(6):W421-W427.
7. Regezi JA, Deegan MJ, Hayward JR. Lichen planus:immunologic and morphologic identification of the submucosal infiltrate[J]. Oral Surg Oral Med Oral Pathol, 1978, 46(1):44-52.
8. Leroy X, Moukassa D, Copin MC, et al. Utility of cytokeratin 7 for distinguishing chromophobe renal cell carcinoma from renaloncocytoma[J]. Eur Urol, 2000, 37(4):484-487.
9. Yasir S, Herrera L, Gomez-Fernandez C, et al. CD10+ and CK7/RON-immunophenotype distinguishes renal cell carcinoma, conventional type with eosinophilic morphology from its mimickers[J]. Appl Immunohistochem Mol Morphol, 2012, 20(5):454-461.
10. Khoubehi BI, Kessling AM, Adshead JM, et al. Expression of the developmental and oncogenic Pax2 gene in human prostate cancer[J]. J Urol, 2001, 165(6, Part 1):2115-2120.
11. Muratovska A, Zhou C, He S, et al. Paired-Box genes are frequently expressed in cancer and often required for cancer cell survival[J]. Oncogene, 2003, 22(39):7989-7997.
12. Carvalho JC, Wasco MJ, Kunju LP, et al. Cluster analysis of immunohistochemical profiles delineates CK7, vimentin, S100A1 and C-kit (CD117) as an optimal panel in the differential diagnosis of renal oncocytoma from its mimics[J]. Histopathology, 2011, 58(2):169-179.
13. Adley BP, Gupta A, Lin F, et al. Expression of kidney-specific cadherin in chromophobe renal cell carcinoma and renal oncocytoma[J]. Am J Clin Pathol, 2006, 126(1):79-85.
14. Gudbjartsson T, Hardarson S, Petursdottir V, et al. Renal oncocytoma:a clinicopathological analysis of 45 consecutive cases[J]. BJU Int, 2005, 96(9):1275-1279.

West China Medical Journal

Differentiation between Chromophobe Cell Renal Carcinoma and Oncocytoma

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