Renal cell carcinoma marker reliably discriminates central nervous system haemangioblastoma from brain metastases of renal cell carcinoma

Aims:  The distinction between central nervous system (CNS) metastases of clear cell renal cell carcinoma (RCC) and CNS haemangioblastoma still poses a challenge to the pathologist. Since both entities occur in von Hippel–Lindau disease, this aggravates the issue. The antibody renal cell carcinoma m...

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Bibliographic Details
Published in:Histopathology 2008-05, Vol.52 (6), p.674-681
Main Authors: Ingold, B, Wild, P J, Nocito, A, Amin, M B, Storz, M, Heppner, F L, Moch, H
Format: Article
Language:English
Subjects:
Antibodies, Monoclonal
Biological and medical sciences
Biomarkers, Tumor - metabolism
brain metastases
Brain Neoplasms - diagnosis
Brain Neoplasms - pathology
Brain Neoplasms - secondary
Carcinoma, Renal Cell - diagnosis
Carcinoma, Renal Cell - pathology
Carcinoma, Renal Cell - secondary
Central Nervous System Neoplasms - pathology
clear cell lesion
haemangioblastoma
Hemangioblastoma - diagnosis
Hemangioblastoma - pathology
Humans
immunohistochemistry
Investigative techniques, diagnostic techniques (general aspects)
Kidney Neoplasms - pathology
Kidneys
Medical sciences
Nephrology. Urinary tract diseases
Neprilysin - immunology
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
RCC marker
renal cell carcinoma
Tissue Array Analysis
tissue microarray
Tumors of the urinary system
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Summary:Aims:  The distinction between central nervous system (CNS) metastases of clear cell renal cell carcinoma (RCC) and CNS haemangioblastoma still poses a challenge to the pathologist. Since both entities occur in von Hippel–Lindau disease, this aggravates the issue. The antibody renal cell carcinoma marker (RCC‐ma) has been suggested to identify primary RCCs specifically, but its value for diagnosing metastases of RCC is controversial. The aim was to assess two distinct clones of the RCC‐ma for their potential to: (i) identify primary RCCs and (ii) differentiate between CNS metastases of clear cell RCC and CNS haemangioblastomas. Methods and results:  Using tissue microarrays, 77% (n = 363; PN‐15) and 66% (n = 355; 66.4C2) of clear cell RCCs, and 93% (PN‐15) and 74% (66.4C2) of papillary RCCs (n = 46) were immunopositive for RCC‐ma, whereas none of the investigated chromophobe RCCs (n = 22) or any of the oncocytomas (n = 15) showed immunoreactivity. Importantly, 50.9% of CNS metastases of clear cell RCCs (n = 55) exhibited RCC‐ma expression, whereas all CNS haemangioblastomas (71) were negative. Conclusions:  Both RCC‐ma clones, despite some variation in their sensitivity to detect clear cell and papillary RCCs, are of value in differentiating subtypes of primary RCC and are excellent markers for discriminating clear cell lesions in the brain.
ISSN:0309-0167
1365-2559
DOI:10.1111/j.1365-2559.2008.03003.x