The Clinicopathologic and Molecular Landscape of Clear Cell Papillary Renal Cell Carcinoma: Implications in Diagnosis and Management

Weng, Stanley; DiNatale, Renzo G.; Silagy, Andrew W.; Mano, Roy; Attalla, Kyrollis; Kashani, Mahyar; Weiss, Kate; Benfante, Nicole; Winer, Andrew; Coleman, Jonathan; Reuter, Victor E.; Russo, Paul; Reznik, Ed; Tickoo, Satish K.; Hakimi, A. Ari

doi:10.1016/j.eururo.2020.09.027

Cited by 37 publications

(33 citation statements)

References 33 publications

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“…These tumors, also described in literature as "clear cell tubulopapillary RCC" [45], represent the 4th most common subtype of RCC (after ccRCC, pRCC and chRCC) [46]. They are frequently cystic (possibly raising differential diagnosis with multilocular cystic RCC, since they can present with only small papillary foci emerging from cystic walls [47]) and display papillary and tubular (tubulopapillary) architecture lined by small cells of low nuclear grade and clear/pale cytoplasm, also showing reversed polarity like PRNRP. The typical immunoexpression of CK7 in a diffuse manner, and the cup-like staining for CAIX together with negativity for AMACR and CD10 clinch the diagnosis.…”

Section: Clear Cell Papillary Rcc and Acquired Cystic Disease-associated Rccmentioning

confidence: 98%

“…The typical immunoexpression of CK7 in a diffuse manner, and the cup-like staining for CAIX together with negativity for AMACR and CD10 clinch the diagnosis. The entity does not harbor VHL or 3p alterations [47]; given the indolent behavior of ccpRCC, the upcoming WHO classification will potentially rename the entity "clear cell papillary renal cell tumor". Diagnosis should be reserved for those tumors fulfilling all criteria, especially in poorly sampled specimens [48].…”

Section: Clear Cell Papillary Rcc and Acquired Cystic Disease-associated Rccmentioning

confidence: 99%

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The Morphological Spectrum of Papillary Renal Cell Carcinoma and Prevalence of Provisional/Emerging Renal Tumor Entities with Papillary Growth

et al. 2021

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Renal cell carcinoma (RCC) represents a heterogeneous disease, encompassing an increasing number of tumor subtypes. Post-2016, the World Health Organization (WHO) classification recognized that the spectrum of papillary renal cell carcinoma is evolving and has long surpassed the dichotomic simplistic “type 1 versus type 2” classification. The differential diagnosis of pRCC includes several new provisional/emerging entities with papillary growth. Type 2 tumors have been cleared out of several confounding entities, now regarded as independent tumors with specific clinical and molecular backgrounds. In this work we describe the prevalence and characteristics of emerging papillary tumor entities in two renal tumor cohorts (one consisting of consecutive papillary tumors from a single institute, the other consisting of consultation cases from several centers). After a review of 154 consecutive pRCC cases, 58% remained type 1 pRCC, and 34% type 2 pRCC. Papillary renal neoplasm with reversed polarity (1.3%), biphasic hyalinizing psammomatous RCC (1.3%), and biphasic squamoid/alveolar RCC (4.5%) were rare. Among 281 consultation cases, 121 (43%) tumors had a dominant papillary growth (most frequently MiT family translocation RCCs, mucinous tubular and spindle cell carcinoma and clear cell papillary RCC). Our data confirm that the spectrum of RCCs with papillary growth represents a major diagnostical challenge, frequently requiring a second expert opinion. Papillary renal neoplasm with reversed polarity, biphasic hyalinizing psammomatous RCC, and biphasic squamoid/alveolar RCC are rarely sent out for a second opinion, but correct classification and knowledge of these variants will improve our understanding of the clinical behavior of renal tumors with papillary growth.

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Section: Clear Cell Papillary Rcc and Acquired Cystic Disease-associated Rccmentioning

confidence: 98%

Section: Clear Cell Papillary Rcc and Acquired Cystic Disease-associated Rccmentioning

confidence: 99%

The Morphological Spectrum of Papillary Renal Cell Carcinoma and Prevalence of Provisional/Emerging Renal Tumor Entities with Papillary Growth

et al. 2021

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“…The incidence rate of RCC has increased in the past two decades [ 3 ]. Approximately, 20–30% of RCC patients will have distant metastasis during the follow-up period after curative surgery [ 3 , 4 ]. However, the treatment of advanced RCC is still a challenge for clinicians, with a 5-year survival rate less than 20% [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, the treatment of advanced RCC is still a challenge for clinicians, with a 5-year survival rate less than 20% [ 5 ]. Clear cell renal cell carcinoma (ccRCC) is the most common subtype, ccRCC accounts for almost 85% of all sorts of RCC [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of spectral CT on tumor microvascular angiogenesis in renal cell carcinoma

Zhang

Qiu

et al. 2021

BMC Cancer

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Background To examine the value of energetic-spectrum computed tomography (spectral CT) quantitative parameters in renal cell carcinoma (RCC) microvascular angiogenesis. Methods The authors evaluated 32 patients with pathologically confirmed RCC who underwent triple-phase contrast-enhanced CT with spectral CT imaging mode from January 2017 to December 2019. Quantitative parameters include parameters derived from iodine concentration (IC) and water concentration (WC) of 120 keV monochromatic images. All specimens were evaluated including the microvascular density (MVD), microvascular area (MVA) and so on. The correlation between IC and WC (including average values and random values) with microvascular parameters were analyzed with Pearson or Spearman rank correlation coefficients. Results The MVD of all tumors was 26.00 (15.00–43.75) vessels per field at × 400 magnification. The MVD of RCC correlated positively with the mean IC, mean WC, mean NWC, mean NIC, random IC, random NIC in renal cortical phase, WCD1, WCD2, NWCD2 and ICD1 (Spearman rank correlation coefficients, r range, 0.362–0.533; all p < 0.05). The MVA of all tumors was (16.16 ± 8.98) % per field at × 400 magnification. The MVA of RCC correlated positively with the mean IC, mean WC, mean NWC, mean NIC, random IC, random NIC in renal cortical, mean WC and mean NWC in renal parenchymal phase, WCD1, WCD2, WCD3, NWCD2, and NWCD3 (Pearson or Spearman rank correlation coefficients, r range, 0.357–0.576; all p < 0.05). Microvascular grading correlated positively with the mean NWC, mean NIC and random NIC in renal cortical phase, mean NWC in renal parenchymal phase, NWCD2, WCD3, NWCD3, NICD2 and NICD3 (Spearman rank correlation coefficients, r range, 0.367–0.520; all p < 0.05). As for tumor diameter (55.19 ± 19.15), μm, only NWCD3 was associated with it (Spearman rank correlation coefficients, r = 0.388; p < 0.05). Conclusions ICD and WCD of spectral CT have a potential for evaluating RCC microvascular angiogenesis. MVD, MVA and microvascular grade showed moderate positive correlation with ICD and WCD. ICD displayed more relevant than that of WCD. The parameters of renal cortical phase were the best in three phases. NICD and NWCD manifested stronger correlation with microvascular parameters than that of ICD and WCD.

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“…Renal cell carcinoma (RCC) is a kind of tumor originated from renal epithelial cells, accounting for more than 90% of renal cell carcinoma, which accounts for 2% of adult malignancies [1,2]. Clear cell renal cell carcinoma (ccRCC) is the most common subtype [3]. Due to the formation of new microvessels, the structure of microvessels in malignant tumors is different from that in normal tumors.…”

Section: Introductionmentioning

confidence: 99%

Effect of Spectral CT on Tumor Microvascular Angiogenesis in Renal Cell Carcinoma

Zhang

Qiu

et al. 2021

Preprint

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Background: To examine the value of spectral CT quantitative parameters in renal cell carcinoma (RCC) microvascular angiogenesis.Methods: The authors evaluated 32 patients with pathologically confirmed RCC who underwent triple-phase contrast-enhanced CT with spectral CT imaging mode from January 2017 to December 2019. Quantitative parameters including the parameters derived from iodine concentration (IC) and water concentration (WC) of 120 keV monochromatic images. The microvascular density (MVD), microvascular area (MVA) and etc. al. of specimens were evaluated. The correlation between IC and WC (including average values and random values) with microvascular parameters were analyzed using Pearson or Spearman rank correlation coefficients.Results: The MVD of all tumors was 26.00 (15.00-43.75) vessels per field at ×400 magnification. The MVD of RCC correlated positively with the mean IC, mean WC, mean NWC, mean NIC, random IC, random NIC in renal cortical phase, WCD1, WCD2, NWCD2 and ICD1 (Spearman rank correlation coefficients, r range, 0.362–0.533; all p < 0.05). The MVA of all tumors was (16.16±8.98) % per field at ×400 magnification. The MVA of RCC correlated positively with the mean IC, mean WC, mean NWC, mean NIC, random IC, random NIC in renal cortical, mean WC and mean NWC in renal parenchymal phase, WCD1, WCD2, WCD3, NWCD2, and NWCD3 (Pearson or Spearman rank correlation coefficients, r range, 0.357–0.576; all p < 0.05). Microvascular grading correlated positively with the mean NWC, mean NIC and random NIC in renal cortical phase, mean NWC in renal parenchymal phase, NWCD2, WCD3, NWCD3, NICD2 and NICD3 (Spearman rank correlation coefficients, r range, 0.367–0.520; all p < 0.05). As for tumor diameter (55.19±19.15), μm, only NWCD3 was associated with it (Spearman rank correlation coefficients, r = 0.388; p < 0.05). Conclusions: IC and WC indexes derived from spectral CT, especially the renal cortical phase, difference between renal cortical phase and parenchymal phase were useful indicators for evaluating tumor angiogenesis. Moreover, the difference of the derived parameters of WC in different phases has stronger correlation with tumor angiogenesis than that of IC.

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The Clinicopathologic and Molecular Landscape of Clear Cell Papillary Renal Cell Carcinoma: Implications in Diagnosis and Management

Cited by 37 publications

References 33 publications

The Morphological Spectrum of Papillary Renal Cell Carcinoma and Prevalence of Provisional/Emerging Renal Tumor Entities with Papillary Growth

The Morphological Spectrum of Papillary Renal Cell Carcinoma and Prevalence of Provisional/Emerging Renal Tumor Entities with Papillary Growth

Effect of spectral CT on tumor microvascular angiogenesis in renal cell carcinoma

Effect of Spectral CT on Tumor Microvascular Angiogenesis in Renal Cell Carcinoma

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