Chromophobe renal cell carcinoma with neuroendocrine and neuroendocrine-like features. Morphologic, immunohistochemical, ultrastructural, and array comparative genomic hybridization analysis of 18 cases and review of the literature

Abstract Chromophobe renal cell carcinoma (CRCC) with neuroendocrine differentiation (CRCCND) has only recently been described. Eighteen cases of CRCC with morphologic features suggestive of neuroendocrine differentiation were selected from among 624 CRCCs in our registry. The tissues were fixed in...

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Published in:Annals of diagnostic pathology 2015-08, Vol.19 (4), p.261-268
Main Authors: Peckova, Kvetoslava, MD, Martinek, Petr, MSc, Ohe, Chisato, MD, Kuroda, Naoto, MD, Bulimbasic, Stela, MD, PhD, Condom Mundo, Enric, MD, Perez Montiel, Delia, MD, Lopez, Jose I., MD, Daum, Ondrej, MD, PhD, Rotterova, Pavla, MD, PhD, Kokoskova, Bohuslava, MD, Dubova, Magdalena, MD, Pivovarcikova, Kristyna, MD, Bauleth, Kevin, MD, Grossmann, Petr, PhD, Hora, Milan, MD, Kalusova, Kristyna, MD, Davidson, Whitney, MD, Slouka, David, MD, PhD, Miroslav, Sulc, MD, Buzrla, Petr, MD, Hynek, Mirka, MD, PhD, Michal, Michal, MD, Hes, Ondrej, MD, PhD
Format: Article
Language:English
Subjects:
aCGH
Adult
Aged
Carcinoma, Renal Cell - genetics
Carcinoma, Renal Cell - metabolism
Carcinoma, Renal Cell - pathology
Chromophobe renal cell carcinoma
Chromosomal numerical aberrations
Comparative Genomic Hybridization
Diagnosis, Differential
Female
Humans
Immunohistochemistry
Kidney
Kidney Neoplasms - genetics
Kidney Neoplasms - metabolism
Kidney Neoplasms - pathology
Male
Middle Aged
Neoplasm Metastasis
Neuroendocrine differentiation
Neuroendocrine Tumors - genetics
Neuroendocrine Tumors - metabolism
Neuroendocrine Tumors - pathology
Pathology
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Summary:Abstract Chromophobe renal cell carcinoma (CRCC) with neuroendocrine differentiation (CRCCND) has only recently been described. Eighteen cases of CRCC with morphologic features suggestive of neuroendocrine differentiation were selected from among 624 CRCCs in our registry. The tissues were fixed in neutral formalin, embedded in paraffin, cut into 4- to 5- μ m-thick sections, and stained with hematoxylin and eosin. As CRCC with neuroendocrine features, tumors with following morphology were suggested: (1) trabecular/palisading/ribbon-like, gyriform, insular, glandular, and solid pattern; (2) uniform polygonal cells formed in small islets; and (3) cribriform pattern in combination with palisading. Selected cases were further analyzed using immunohistochemistry, electron microscopy, array comparative genomic hybridization, and fluorescence in situ hybridization. Cases were classified as CRCCND or CRCC with neuroendocrine-like features (CRCCND-L) based on the immunohistochemical expression of neuroendocrine markers: CRCCND, 4 cases, age range 49 to 79 years, size ranged from 2.2 to 22 cm, and CRCCND-L, 14 cases, age range 34 to 74 years, size range 3.8 to 16.5 cm. Follow-up information was available for 11 of 18 patients aged 0.5 to 12 years. Two of 4 CRCCNDs showed aggressive clinical course with metastatic spreading. Chromophobe renal cell carcinomas with neuroendocrine differentiation were focally positive for CD56 (4/4), synaptophysin (4/4), chromogranin A (1/4), and neuron-specific enolase (3/4). All 14 CRCCND-Ls were mostly negative or very weakly focally positive for some of the aforementioned markers. All 18 tumors were positive for cytokeratin 7 and CD117. Ultrastructural analysis showed poorly preserved neuroendocrine granules only in 2 of 4 analyzed CRCCNDs. Losses of chromosomes 1, 2, 6, and 10 were found in all analyzable CRCCNDs, whereas multiple losses (chromosomes 1, 2, 6, 10, 13, 17, and 21) and gains (chromosomes 4, 11, 12, 14, 15, 16, 19, and 20) were found in CRCCND-L.
ISSN:1092-9134
1532-8198
DOI:10.1016/j.anndiagpath.2015.05.001