Abstract
Renal oncocytoma (RO) may present with a tubulo-cystic growth pattern in 3–7% of cases. In such cases its morphology may significantly overlap with tubulocystic renal cell carcinoma (TCRCC). We compared the morphological and immunohistochemical characteristics of these tumors aiming to clarify the differential diagnostic criteria and facilitating their discrimination. Twenty-four cystic RO (CRO) and 17 TCRCC were selected and analyzed for architectural pattern, stromal features, cytological criteria, necrosis, nuclear grade and mitotic activity. Immunohistochemical panel including various cytokeratins, vimentin, CD10, AMACR, antimitochondrial antigen (MIA), EMA and Ki-67. The islands of tumor cells, myxoid stroma, lower nuclear grade, absence of necrosis and mitotic figures were strongly suggestive of diagnosis of CRO while the absence of islands of tumor cells, fibrotic stroma, higher nuclear grade and presence of necrosis and mitoses were strongly suggestive of TCRCC. Immunohistochemical analysis of vimentin, CK7, CD10, AMACR and Ki-67 may discriminate between CRO and TCRCC. Islands of tumor cells and type of stroma may be major morphologic criteria for differentiating between CRO and TCRCC. In difficult cases, or cases when limited specimen availability precludes the assessment of morphologic criteria, immunohistochemical markers such as vimentin, CK7, CD10, AMACR and CK7 could lead to correct diagnosis.
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