Modern Pathologic Diagnosis of Renal Oncocytoma.

Sara E Wobker,Sean R Williamson

doi:10.15586/jkcvhl.2017.96

Abstract

Oncocytoma is a well-defined benign renal tumor, with classic gross and histologic features, including a tan or mahogany-colored mass with central scar, microscopic nested architecture, bland cytology, and round, regular nuclei with prominent central nucleoli. As a result of variations in this classic appearance, difficulty in standardizing diagnostic criteria, and entities that mimic oncocytoma, such as eosinophilic variant chromophobe renal cell carcinoma and succinate dehydrogenase-deficient renal cell carcinoma, pathologic diagnosis remains a challenge. This review addresses the current state of pathologic diagnosis of oncocytoma, with emphasis on modern diagnostic markers, areas of controversy, and emerging techniques for less invasive diagnosis, including renal mass biopsy and advanced imaging.

Highlights

Oncocytoma has been recognized for decades [1, 2] as a distinct subtype of benign renal tumor; despite evaluation of numerous biomarkers performed over the years [3, 4], pathologic diagnosis of oncocytoma and distinction from its mimics remain a challenge, even today [5]
This review addresses the current state of pathologic diagnosis of oncocytoma, with emphasis on modern diagnostic markers, areas of controversy, and emerging techniques for less invasive diagnosis, including renal mass biopsy and specialized imaging techniques
A central scar can be found in chromophobe renal cell carcinoma, as well as other slow growing neoplasms, and substantial hyalinization and fibrosis can be present within clear cell renal cell Journal of Kidney Cancer and VHL 2017; 4(4): 1–12

Summary

Introduction

Oncocytoma has been recognized for decades [1, 2] as a distinct subtype of benign renal tumor; despite evaluation of numerous biomarkers performed over the years [3, 4], pathologic diagnosis of oncocytoma and distinction from its mimics remain a challenge, even today [5]. A diploid karyotype or loss of chromosome 1 in the appropriate morphologic and immunohistochemical context can be considered supportive of an oncocytoma diagnosis, whereas other losses or other alterations not typical of oncocytoma might be used to favor a borderline diagnosis or classification as chromophobe renal cell carcinoma.

Results

Conclusion