Chromophobe renal cell carcinoma with calcification: Report of a case with rare finding on aspiration smears

Abstract

Chromophobe renal cell carcinoma (ChRCC) is a distinct variant of renal cell carcinoma. It is important to identify this entity because it has a significantly better prognosis than clear cell (conventional) renal cell carcinoma. We report the case of a 56-year-old male who presented with 10 days history of painless hematuria. There was no palpable swelling or systemic symptoms. On radiological examination the possibility of a right renal neoplasm was considered. Ultrasound guided aspiration was done and cytological features of ChRCC were noted. In addition, numerous foci of calcification were seen, which was an unusual cytological feature for ChRCC. The characteristic cytomorphology of ChRCC makes it possible to render a preoperative diagnosis on fine needle aspiration cytology (FNAC). We report the case to emphasize the importance and possibility of diagnosing of ChRCC on cytology. In addition, the extensive calcification as seen in our case is an unusual cytological finding not previously reported in cytology smears.

FNAC Diagnosis of eosinophilic variant of chromophobe renal cell carcinoma – A challenge for cytopathologists

“…The distinctive cytological features of this variant have been described earlier in few published reports and it is possible to identify this variant of RCC. 9 Cytomorphology of ChRCC shows a characteristic pattern that allows differentiation from other renal cell tumours. Most smears show prominent cellular heterogeneity, pleomorphism, perinuclear halos and binucleation.…”

“…Most smears show prominent cellular heterogeneity, pleomorphism, perinuclear halos and binucleation. 9 The cellular heterogeneity is one of the most reliable features of ChRCC. 10 Akhtar and Ali have first described this cellular polymorphism in ChRCC.…”

“…1,6 Bi-nucleate and multinucleate tumour cells are common. 9 The cells have abundant granular to fluffy cytoplasm with perinuclear clearing (halos) and distinct cell borders classically described as 'plant-like' or 'koilocyte-like' tumour cells. 1,10 In addition to these findings seen in classic variant of ChRCC, our case showed predominance of cells with abundant granular eosinophilic cytoplasm giving superficial resemblance to Oncocytoma prompting us to label it as eosinophilic variant of ChRCC.…”

“…We reviewed all 12 articles published so far on cytodiagnosis of ChRCC. [1][2][3][4][5][6][7][8][9][10][11][12] The previously published cytological reports of ChRCC are summarised in Table 1. Overall 39 cases of ChRCC have been reported so far, of which 32 are in kidney.…”