Abstract
Collecting duct carcinoma (CDC) with a mass of coagulative necrosis is very rare. We report here a case of CDC with extensive geographic coagulative necrosis mimicking anemic infarct with tumor cells embedded around the necrotic foci in a 73-years-old man. Histopathological examination showed that tumor nests near the necrotic foci were arranged as angulated tubules, tubulopapillary and glandular structures. Neoplastic cells had moderate to abundant eosinophilic cytoplasm and large hyperchromatic nuclei with prominent nucleoli as Fuhrman nuclear grade 3 or 4. The tumor cells were positive for pan-Cytokeratin, Vimentin, E-cadherin, CD10, and CK7, confirming the diagnosis as CDC. The patient is still alive 6 months later from nephrectomy, a long time following up is needed to learn the prognosis. Conclusively, morphology from different portions of the lesion, immunohistochemical stain and the combination analysis of the radiological features is essential to make a precise pathological diagnosis of CDC. And CDC should also be distinguished from clear cell renal cell carcinoma, renal medullary carcinoma, urothelial carcinoma with glandular differentiation, renal neuroendocrine tumor, renal epithelioid angiomyolipoma, renal pigmented paraganglioma and renal mesenchymal chondrosarcoma etc.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1264270525975030
Highlights
Adult renal tumors comprise a range of distinct clinicopathologic subtypes with differing clinical and/or syndrome associations, gross, microscopic, immunohistochemical characteristics
Collecting duct carcinoma (CDC) of the kidney is an unusual variant of renal cell carcinoma
In contrast to previously cases, we present here a CDC case with extensive necrosis and cystic formation in an old male patient, which were seldom observed in this type tumor of kidney
Summary
Adult renal tumors comprise a range of distinct clinicopathologic subtypes with differing clinical and/or syndrome associations, gross, microscopic, immunohistochemical characteristics. Collecting duct carcinoma (CDC) of the kidney is an unusual variant of renal cell carcinoma. It originates from the epithelium of the collecting tubule and accounts for less than 1% of the incidence of renal epithelial neoplasms [1]. CDC was firstly reported by Foot and Papanicolaou in 1949 [2] It was formally recognized as an unique clinicopathologic subtype of RCC following the report and description of 6 new cases by Fleming and Lewi in 1986 [3]. In contrast to previously cases, we present here a CDC case with extensive necrosis and cystic formation in an old male patient, which were seldom observed in this type tumor of kidney. The clinicopathological features of this case and the differential diagnosis was been discussed
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