Korean J Pathol.  2013 Oct;47(5):426-432.

Histologic Variations and Immunohistochemical Features of Metastatic Clear Cell Renal Cell Carcinoma

• Lee C
• Park JW
• Suh JH
• Nam KH
• Moon KC

Abstract

BACKGROUND
Due to advancements in treatment of metastatic and advanced renal cell carcinoma (RCC), it has become increasingly important to diagnose metastatic RCC and the specific subtype. In this study, we investigated the diverse histologic features of metastatic clear cell renal cell carcinoma (CCRCC) cases in comparison with corresponding primary lesions.
METHODS
We identified 119 metastatic CCRCC cases from 81 corresponding primary lesions diagnosed between 1995 and 2010 and evaluated the diverse histologic and immunohistochemical features of these lesions.
RESULTS
A total of 44 primary lesions (54.3%) had a non-clear cell component in addition to a typical clear cell component. Of the 119 metastatic lesions, 63 lesions (52.9%) contained a non-clear cell component, and 29 metastatic lesions were composed of a non-clear cell component only. Rhabdoid features were the most frequent non-clear cell histology among the metastatic lesions. Metastatic CCRCCs mainly showed positive CD10 and epithelial membrane antigen staining and negative cytokeratin 7 staining.
CONCLUSIONS
Metastatic CCRCC commonly showed a variety of histologic features. If there is a difficulty to diagnose metastatic CCRCC due to a variety of histologic features or small biopsy specimen, histologic review of the primary lesion and immunohistochemical analysis can help determine the correct diagnosis.

Keyword

Carcinoma, renal cell; Clear cell; Neoplasm metastasis; Histology; Immunohistochemistry

MeSH Terms

Biopsy
Carcinoma, Renal Cell*
Cellular Structures
Immunohistochemistry
Keratin-7
Mucin-1
Neoplasm Metastasis
Keratin-7
Mucin-1