Unclassified hemangioma-like renal cell carcinoma: a potential diagnostic pitfall

Document Type

Article

Publication Date

5-1-2018

Publication Title

Human pathology

Keywords

Carcinoma, Renal Cell/diagnosis/pathology, Diagnosis, Differential, Female, Hemangioma/diagnosis/pathology, Humans, Kidney Neoplasms/diagnosis/pathology, Middle Aged, Clear cell renal cell carcinoma, Hemangioma, Immunohistochemistry, Kidney cancer, Partial nephrectomy, Unclassified renal cell carcinoma

Abstract

Recently, rare renal cell carcinomas (RCCs) have been reported to closely mimic hemangioma; however, these have been largely recognizable as clear cell RCC. Conversely, true hemangiomas of the kidney are also increasingly recognized. We report a 62-year-old woman who underwent partial nephrectomy for a hemangioma-like RCC without appreciable clear cell morphology. Immunohistochemistry revealed luminal structures that stained positively for cytokeratin, cytokeratin 7, carbonic anhydrase IX, PAX8, and high-molecular-weight keratin, admixed with a CD34-positive, CD31-positive, and ERG-positive complex network of vessels. Staining was minimal for α-methyl-acyl-coA-racemase and EMA, and absent for GATA3, HMB45, melan-A, and cathepsin K. Fluorescence in situ hybridization revealed no TFE3 or TFEB rearrangement, 3p deletion, or trisomy 7 or 17. This case adds to the spectrum of hemangioma-like RCC with differing morphology and immunophenotype. Further study will determine whether this represents a distinct entity or an unusual pattern of degenerative changes in an existing entity.

Medical Subject Headings

Carcinoma; Renal Cell/diagnosis/pathology; Diagnosis; Differential; Female; Hemangioma/diagnosis/pathology; Humans; Kidney Neoplasms/diagnosis/pathology; Middle Aged; Clear cell renal cell carcinoma; Hemangioma; Immunohistochemistry; Kidney cancer; Partial nephrectomy; Unclassified renal cell carcinoma

PubMed ID

29104112

Volume

75

First Page

132

Last Page

136

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