Low-grade myxoid renal epithelial neoplasms with distal nephron differentiation

Anil V. Parwani, Aliya N. Husain, Jonathan I. Epstein, J. Bruce Beckwith, Pedram Argani

Research output: Contribution to journalArticlepeer-review

Abstract

We report 4 distinctive renal epithelial neoplasms that are essentially identical at the morphologic and immunohistochemical levels and do not fit an accepted category in the existing classification of these lesions. The patients were all females, with ages ranging from 32 to 79 years (mean, 50 years). The tumors were well circumscribed and were composed of uniform, predominantly low cuboidal cells with eosinophilic, focally vacuolated cytoplasm. Tumor cells generally formed interconnecting tubules, with smaller areas of cordlike growth and spindling in a bubbly, myxoid stroma. All tumors were confined to the kidneys and all were immunoreactive for high-molecular-weight cytokeratin 34βE12, cytokeratin 7, epithelial membrane antigen, and cytokeratin cocktail AE1/3. Only 1 tumor was focally immunoreactive for Ulex europaens agglutinin. Ultrastructural study showed tumor cells forming tubular structures reminiscent of the loop of Henle or distal convoluted tubule. Follow-up in all 4 cases was benign. These distinctive tumors may be confused with aggressive sarcomatoid renal cell carcinomas because of their spindled morphology. The morphologic, immunohistochemical, and ultrastructural features of these lesions indicate differentiation toward distal nephron segments. Similar tumors probably have been reported among low-grade collecting duct carcinomas or tumors "possibly related to the loop of Henle.".

Original languageEnglish (US)
Pages (from-to)506-512
Number of pages7
JournalHuman pathology
Volume32
Issue number5
DOIs
StatePublished - 2001

Keywords

  • Collecting duct carcinoma
  • Loop of Henle
  • Renal neoplasm

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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