Clear cell papillary renal cell carcinoma with angiomyomatous stroma: A histological, immunohistochemical, and fluorescence in situ hybridization study

Borislav A. Alexiev, Carrie Thomas, Ying Zou

Research output: Contribution to journalArticle

Abstract

Clear cell papillary renal cell carcinoma (CCPRCC) is a novel tumor entity that was recently recognized as a new distinct epithelial tumor within the current classification system. Nonclassic morphologic variants have rarely been reported. We present six challenging cases of CCPRCC with prominent (>75 %) tubular, acinar, and/or solid component and angioleiomyomatous stroma. The tumors lacked well-organized papillary architecture. All tumors had a variously thick capsule formed by a layer of bands of smooth muscle. The leiomyomatous tissue often entirely encased patches of tubular structures, or it formed only small leiomyomatous islands within the epithelial component. There was a remarkable relationship between the vascular network and the epithelial component in the sense that every single tubule or acinus was associated with a fine capillary network, with the capillaries intimately surrounding the tubular or acinar circumference. CCPRCC with variant morphology expressed carbonic anhydrase IX (CA-IX) in cup-shaped distribution. In addition, the tumor cells stained positive for cytokeratin 34betaE12, CK7, and vimentin. Renal cell carcinoma (RCC), P504s/AMACR, Melan A, and HMB45 were negative in tumor cells in all cases examined. Fluorescence in situ hybridization studies showed the presence of a normal copy number for chromosomes 7, 17, 3q, and 3p. CCPRCC with variant morphology seems to have a favorable prognosis. In the current series, tumor stage was low at presentation, and none of the patients had local recurrence or metastatic disease. The distinction between CCPRCC with variant morphology and clear cell RCC is critical because no case of CCPRCC has behaved aggressively.

Original languageEnglish (US)
Pages (from-to)709-716
Number of pages8
JournalVirchows Archiv
Volume464
Issue number6
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Fluorescence In Situ Hybridization
Renal Cell Carcinoma
Neoplasms
MART-1 Antigen
Chromosomes, Human, Pair 17
Chromosomes, Human, Pair 7
Vimentin
Keratins
Islands
Capsules
Smooth Muscle
Blood Vessels

Keywords

  • Clear cell papillary renal cell carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Molecular Biology
  • Cell Biology

Cite this

Clear cell papillary renal cell carcinoma with angiomyomatous stroma : A histological, immunohistochemical, and fluorescence in situ hybridization study. / Alexiev, Borislav A.; Thomas, Carrie; Zou, Ying.

In: Virchows Archiv, Vol. 464, No. 6, 01.01.2014, p. 709-716.

Research output: Contribution to journalArticle

@article{a79cc28613dc4395a4972cb3b08db9e1,
title = "Clear cell papillary renal cell carcinoma with angiomyomatous stroma: A histological, immunohistochemical, and fluorescence in situ hybridization study",
abstract = "Clear cell papillary renal cell carcinoma (CCPRCC) is a novel tumor entity that was recently recognized as a new distinct epithelial tumor within the current classification system. Nonclassic morphologic variants have rarely been reported. We present six challenging cases of CCPRCC with prominent (>75 {\%}) tubular, acinar, and/or solid component and angioleiomyomatous stroma. The tumors lacked well-organized papillary architecture. All tumors had a variously thick capsule formed by a layer of bands of smooth muscle. The leiomyomatous tissue often entirely encased patches of tubular structures, or it formed only small leiomyomatous islands within the epithelial component. There was a remarkable relationship between the vascular network and the epithelial component in the sense that every single tubule or acinus was associated with a fine capillary network, with the capillaries intimately surrounding the tubular or acinar circumference. CCPRCC with variant morphology expressed carbonic anhydrase IX (CA-IX) in cup-shaped distribution. In addition, the tumor cells stained positive for cytokeratin 34betaE12, CK7, and vimentin. Renal cell carcinoma (RCC), P504s/AMACR, Melan A, and HMB45 were negative in tumor cells in all cases examined. Fluorescence in situ hybridization studies showed the presence of a normal copy number for chromosomes 7, 17, 3q, and 3p. CCPRCC with variant morphology seems to have a favorable prognosis. In the current series, tumor stage was low at presentation, and none of the patients had local recurrence or metastatic disease. The distinction between CCPRCC with variant morphology and clear cell RCC is critical because no case of CCPRCC has behaved aggressively.",
keywords = "Clear cell papillary renal cell carcinoma",
author = "Alexiev, {Borislav A.} and Carrie Thomas and Ying Zou",
year = "2014",
month = "1",
day = "1",
doi = "10.1007/s00428-014-1581-y",
language = "English (US)",
volume = "464",
pages = "709--716",
journal = "Virchows Archiv",
issn = "0945-6317",
publisher = "Springer Verlag",
number = "6",

}

TY - JOUR

T1 - Clear cell papillary renal cell carcinoma with angiomyomatous stroma

T2 - A histological, immunohistochemical, and fluorescence in situ hybridization study

AU - Alexiev, Borislav A.

AU - Thomas, Carrie

AU - Zou, Ying

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Clear cell papillary renal cell carcinoma (CCPRCC) is a novel tumor entity that was recently recognized as a new distinct epithelial tumor within the current classification system. Nonclassic morphologic variants have rarely been reported. We present six challenging cases of CCPRCC with prominent (>75 %) tubular, acinar, and/or solid component and angioleiomyomatous stroma. The tumors lacked well-organized papillary architecture. All tumors had a variously thick capsule formed by a layer of bands of smooth muscle. The leiomyomatous tissue often entirely encased patches of tubular structures, or it formed only small leiomyomatous islands within the epithelial component. There was a remarkable relationship between the vascular network and the epithelial component in the sense that every single tubule or acinus was associated with a fine capillary network, with the capillaries intimately surrounding the tubular or acinar circumference. CCPRCC with variant morphology expressed carbonic anhydrase IX (CA-IX) in cup-shaped distribution. In addition, the tumor cells stained positive for cytokeratin 34betaE12, CK7, and vimentin. Renal cell carcinoma (RCC), P504s/AMACR, Melan A, and HMB45 were negative in tumor cells in all cases examined. Fluorescence in situ hybridization studies showed the presence of a normal copy number for chromosomes 7, 17, 3q, and 3p. CCPRCC with variant morphology seems to have a favorable prognosis. In the current series, tumor stage was low at presentation, and none of the patients had local recurrence or metastatic disease. The distinction between CCPRCC with variant morphology and clear cell RCC is critical because no case of CCPRCC has behaved aggressively.

AB - Clear cell papillary renal cell carcinoma (CCPRCC) is a novel tumor entity that was recently recognized as a new distinct epithelial tumor within the current classification system. Nonclassic morphologic variants have rarely been reported. We present six challenging cases of CCPRCC with prominent (>75 %) tubular, acinar, and/or solid component and angioleiomyomatous stroma. The tumors lacked well-organized papillary architecture. All tumors had a variously thick capsule formed by a layer of bands of smooth muscle. The leiomyomatous tissue often entirely encased patches of tubular structures, or it formed only small leiomyomatous islands within the epithelial component. There was a remarkable relationship between the vascular network and the epithelial component in the sense that every single tubule or acinus was associated with a fine capillary network, with the capillaries intimately surrounding the tubular or acinar circumference. CCPRCC with variant morphology expressed carbonic anhydrase IX (CA-IX) in cup-shaped distribution. In addition, the tumor cells stained positive for cytokeratin 34betaE12, CK7, and vimentin. Renal cell carcinoma (RCC), P504s/AMACR, Melan A, and HMB45 were negative in tumor cells in all cases examined. Fluorescence in situ hybridization studies showed the presence of a normal copy number for chromosomes 7, 17, 3q, and 3p. CCPRCC with variant morphology seems to have a favorable prognosis. In the current series, tumor stage was low at presentation, and none of the patients had local recurrence or metastatic disease. The distinction between CCPRCC with variant morphology and clear cell RCC is critical because no case of CCPRCC has behaved aggressively.

KW - Clear cell papillary renal cell carcinoma

UR - http://www.scopus.com/inward/record.url?scp=84902311385&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84902311385&partnerID=8YFLogxK

U2 - 10.1007/s00428-014-1581-y

DO - 10.1007/s00428-014-1581-y

M3 - Article

C2 - 24771120

AN - SCOPUS:84902311385

VL - 464

SP - 709

EP - 716

JO - Virchows Archiv

JF - Virchows Archiv

SN - 0945-6317

IS - 6

ER -