Acceptance of emerging renal oncocytic neoplasms: a survey of urologic pathologists
Recommended Citation
Mohanty SK, Lobo A, Jha S, Sangoi AR, Akgul M, Trpkov K, Hes O, Mehra R, Hirsch MS, Moch H, Smith SC, Shah RB, Cheng L, Amin MB, Epstein JI, Parwani AV, Delahunt B, Desai S, Przybycin CG, Manini C, Luthringer DJ, Sirohi D, Jain D, Midha D, Jain E, Maclean F, Giannico GA, Paner GP, Martignoni G, Al-Ahmadie HA, McKenney J, Srigley JR, Lopez JI, Kunju LP, Browning L, Aron M, Picken MM, Tretiakova M, Zhou M, Sable M, Kuroda N, Pattnaik N, Gupta NS, Rao P, Fine SW, Mishra P, Adhya AK, Kulkarni BN, Dixit M, Baisakh MR, Arora S, Sancheti S, Menon S, Wobker SE, Tickoo SK, Kaushal S, Soni S, Kandukuri S, Sharma S, Mitra S, Reuter VE, Malik V, Rao V, Chen YB, and Williamson SR. Acceptance of emerging renal oncocytic neoplasms: a survey of urologic pathologists. Virchows Arch 2024.
Document Type
Article
Publication Date
9-17-2024
Publication Title
Virchows Archiv
Abstract
Oncocytic renal neoplasms are a major source of diagnostic challenge in genitourinary pathology; however, they are typically nonaggressive in general, raising the question of whether distinguishing different subtypes, including emerging entities, is necessary. Emerging entities recently described include eosinophilic solid and cystic renal cell carcinoma (ESC RCC), low-grade oncocytic tumor (LOT), eosinophilic vacuolated tumor (EVT), and papillary renal neoplasm with reverse polarity (PRNRP). A survey was shared among 65 urologic pathologists using SurveyMonkey.com (Survey Monkey, Santa Clara, CA, USA). De-identified and anonymized respondent data were analyzed. Sixty-three participants completed the survey and contributed to the study. Participants were from Asia (n = 21; 35%), North America (n = 31; 52%), Europe (n = 6; 10%), and Australia (n = 2; 3%). Half encounter oncocytic renal neoplasms that are difficult to classify monthly or more frequently. Most (70%) indicated that there is enough evidence to consider ESC RCC as a distinct entity now, whereas there was less certainty for LOT (27%), EVT (29%), and PRNRP (37%). However, when combining the responses for sufficient evidence currently and likely in the future, LOT and EVT yielded > 70% and > 60% for PRNRP. Most (60%) would not render an outright diagnosis of oncocytoma on needle core biopsy. There was a dichotomy in the routine use of immunohistochemistry (IHC) in the evaluation of oncocytoma (yes = 52%; no = 48%). The most utilized IHC markers included keratin 7 and 20, KIT, AMACR, PAX8, CA9, melan A, succinate dehydrogenase (SDH)B, and fumarate hydratase (FH). Genetic techniques used included TSC1/TSC2/MTOR (67%) or TFE3 (74%) genes and pathways; however, the majority reported using these very rarely. Only 40% have encountered low-grade oncocytic renal neoplasms that are deficient for FH. Increasing experience with the spectrum of oncocytic renal neoplasms will likely yield further insights into the most appropriate work-up, classification, and clinical management for these entities.
PubMed ID
39287823
ePublication
ePub ahead of print
