Biphasic papillary renal cell carcinoma is a rare morphological variant with frequent multifocality: a study of 28 cases

Biphasic papillary renal cell carcinoma is a rare morphological variant with frequent... IntroductionBiphasic squamoid alveolar renal cell carcinoma (RCC) was recently proposed as a distinctive subtype of papillary RCC by Hes et al. Their study included 21 cases with detailed clinicopathological, immunohistochemical and molecular evaluation, and represented a follow‐up of their initial study of two RCCs with this type of morphology. The key feature of this entity is the biphasic morphology showing a dual cell population—larger eosinophilic cells with abundant cytoplasm and higher‐grade nuclei, usually clustered in aggregates or nests resembling alveolar structures, and a smaller cell population of cuboidal and amphophilic cells with scanty cytoplasm that surround and are admixed with the larger cells. Emperipolesis, composed of neutrophils and cell fragments and debris, was observed in the larger cells in all cases. Using immunohistochemistry, Hes et al. found uniform reactivity for cytokeratin (CK) 7, α‐methylacyl‐CoA racemase (AMACR), epithelial membrane antigen (EMA), and vimentin, as well as striking cyclin D1 positivity restricted to only the larger cells, along with gains of chromosomes 7 and 17. The immunohistochemical (IHC) and the molecular data strongly supported their morphological impression that this entity represented a variant of papillary RCC. With the exception of the study by Hes et al., the insights into this entity http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Histopathology Wiley
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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
Copyright © 2018 John Wiley & Sons Ltd
ISSN
0309-0167
eISSN
1365-2559
D.O.I.
10.1111/his.13432
Publisher site
See Article on Publisher Site

Abstract

IntroductionBiphasic squamoid alveolar renal cell carcinoma (RCC) was recently proposed as a distinctive subtype of papillary RCC by Hes et al. Their study included 21 cases with detailed clinicopathological, immunohistochemical and molecular evaluation, and represented a follow‐up of their initial study of two RCCs with this type of morphology. The key feature of this entity is the biphasic morphology showing a dual cell population—larger eosinophilic cells with abundant cytoplasm and higher‐grade nuclei, usually clustered in aggregates or nests resembling alveolar structures, and a smaller cell population of cuboidal and amphophilic cells with scanty cytoplasm that surround and are admixed with the larger cells. Emperipolesis, composed of neutrophils and cell fragments and debris, was observed in the larger cells in all cases. Using immunohistochemistry, Hes et al. found uniform reactivity for cytokeratin (CK) 7, α‐methylacyl‐CoA racemase (AMACR), epithelial membrane antigen (EMA), and vimentin, as well as striking cyclin D1 positivity restricted to only the larger cells, along with gains of chromosomes 7 and 17. The immunohistochemical (IHC) and the molecular data strongly supported their morphological impression that this entity represented a variant of papillary RCC. With the exception of the study by Hes et al., the insights into this entity

Journal

HistopathologyWiley

Published: Jan 1, 2018

Keywords: ; ; ; ; ; ;

References

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