A renal cell carcinoma with components of both chromophobe and papillary carcinoma

Abstract

We report a case of a morphologically unusual renal cell carcinoma with features of both chromophobe and papillary carcinoma. Immunohistochemical analysis of high molecular weight cytokeratins (HMWCK), cytokeratin 7 (CK7), cytokeratin 19 (CK19), c-Kit, and alpha-methylacyl-CoA racemase (AMACR) demonstrated differential profiles for the two components of the tumor, consistent with the respective patterns commonly observed for pure chromophobe and papillary renal cell carcinomas. Specifically, the chromophobe tumor cells expressed CK7 and c-Kit weakly, while HMWCK, CK19, and AMACR were not detectable. In contrast, the papillary tumor cells expressed uniformly HMWCK, CK7, and c-Kit and focally CK19 and AMACR. Fluorescence in situ hybridization analysis of nuclei isolated from paraffin-embedded tumor tissue detected monosomy 1, disomy 7, and monosomy 17, a common and characteristic finding in chromophobe carcinomas, in a majority of, but not all tumor cells, whereas a population characterized by disomy 1, trisomy 7, and trisomy 17, a frequent finding in papillary carcinoma, was not identifiable. Electron microscopic analysis revealed numerous characteristic small cytoplasmic vesicles in the chromophobe areas, which were absent in the papillary component. This case illustrates the rare coexistence of two distinct and admixed histologic types of renal cell carcinoma.

Two Different Renal Cell Carcinomas and Multiple Angiomyolipomas in a Patient with Tuberous Sclerosis

“…There have been occasional reports and brief references to the simultaneous occurrence of RCC and a variety of benign and malignant renal neoplasms within a single kidney [2-4]. The majority of these reports consisted of one type of RCC combined with a benign renal tumor, such as oncocytoma or AML, or even an adrenal adenoma [5,6].…”

“…The presence of different subtypes of RCC or RCC with other renal neoplasms within the same kidney is extremely unusual. There have been rare reports of the simultaneous occurrence of RCC and a variety of benign and malignant renal neoplasms within the same kidney [2-4]. The most frequently reported combinations are RCC with oncocytoma, angiomyolipoma, and RCC of a dissimilar histological subtype.…”

Collision tumor of the kidney composed of clear cell carcinoma and collecting duct carcinoma: report of a case with unusual morphology and clinical follow up

“…The reported cases of renal collision tumors have included collecting duct carcinoma arising in conjunction with chromophobe RCC, or papillary RCC[2]–[5]. Other reported tumor combinations have included chromophobe RCC and oncocytoma arising in association with papillary RCC[5]–[7]. Cho et al [1].…”

Renal Cell Carcinoma and Other Concurrent Renal Neoplasms

“…There have been occasional reports and brief references to the simultaneous occurrence of renal cell carcinoma and a variety of benign and malignant renal neoplasms within a single kidney. [1][2][3] The most frequently reported associations are renal cell carcinoma with oncocytoma, angiomyolipoma and renal cell carcinoma of a dissimilar histological subtype. Other rare coexisting neoplasms are capsular leiomyoma and hematological malignancy.…”

“…3 Typically at least 1 tumor type is papillary renal carcinoma coexisting with chromophobe or clear cell carcinoma (figs. 1 and 2).…”