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Presented by Dr. Argani and prepared by J. Stephen Nix
This is a 43 year old female with a renal mass.
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1. Question
This is a 43 year old female with a renal mass.
Correct
Answer: C
Histologic Description: This renal epithelial neoplasm is composed of mainly eosinophilic cells. The cells have variable cytoplasm. Some have voluminous cytoplasm, but other are smaller and focally clustered around hyaline material. The neoplasm demonstrated patchy immunoreactivity for HMB45, diffuse labeling for cathepsin K, and demonstrated a TFEB gene rearrangement by FISH.
Differential Diagnosis: SDHB associated renal cell carcinomas have eosinophilic cytoplasm, but typically demonstrate hyaline cytoplasmic inclusions and vacuolization. Fumarate hydratase deficient renal cell carcinomas typically demonstrate strikingly prominent nucleoli with perinucleolar halos. Oncocytomas typically have a more nested pattern, and lack the nuclear variations seen in the current case.
t(6;11) renal cell carcinomas harbor a MALAT1-TFEB gene fusion. They are included with the Xp11 translocation carcinomas in the family MiT family translocation carcinomas of the kidney.
Reference Argani P. MiT family translocation renal cell carcinomas. Seminars in Diagnostic Pathology 2015; 32:103-113.
Incorrect
Answer: C
Histologic Description: This renal epithelial neoplasm is composed of mainly eosinophilic cells. The cells have variable cytoplasm. Some have voluminous cytoplasm, but other are smaller and focally clustered around hyaline material. The neoplasm demonstrated patchy immunoreactivity for HMB45, diffuse labeling for cathepsin K, and demonstrated a TFEB gene rearrangement by FISH.
Differential Diagnosis: SDHB associated renal cell carcinomas have eosinophilic cytoplasm, but typically demonstrate hyaline cytoplasmic inclusions and vacuolization. Fumarate hydratase deficient renal cell carcinomas typically demonstrate strikingly prominent nucleoli with perinucleolar halos. Oncocytomas typically have a more nested pattern, and lack the nuclear variations seen in the current case.
t(6;11) renal cell carcinomas harbor a MALAT1-TFEB gene fusion. They are included with the Xp11 translocation carcinomas in the family MiT family translocation carcinomas of the kidney.
Reference Argani P. MiT family translocation renal cell carcinomas. Seminars in Diagnostic Pathology 2015; 32:103-113.
