Abstract
Pediatric renal tumors overlap histomorphologically and may cause misdiagnosis. We aimed to determine the role of immunohistochemical staining of Cyclin D1, PTEN, beta-catenin and PDGFR-alpha on pediatric renal tumors. Thirty-six cases of 8 different tumors were included in the study. Four blocks of paraffin tissue microarray were constructed. Cyclin D1, PTEN, beta-catenin and PDGFR-alpha were used in all cases. Staining intensity and extent were graded. All cases of clear cell sarcoma (CCS) and epithelial components of Wilms tumor (WT) showed immunopositivity for Cyclin D1 but blastemal and stromal components of WT were negative. All cases of CCS and most cases of WT consisting of blastemal and stromal components demonstrated loss of expression with PTEN. Cyclin D1 is not a specific immunohistochemical marker due to its strong and diffuse positivity in CCS cases. It may be useful to differentiate CCS from blastemal and stromal components of WT. Other markers except cyclin D1 do not have a role in the differential diagnosis.
Highlights
Wilms tumor (WT) is the most common genitourinary tumor of the children aged between 2-4 years
Clear cell sarcoma, atypical teratoid rhabdoid tumor, and mesoblastic nephroma are pediatric renal tumors and less frequently Ewing sarcoma has been reported in this localization
We investigated the role of these immunohistochemical markers in the differential diagnosis: there are studies suggesting that immunohistochemical markers can be helpful in these tumors, immunohistochemistry is limited in the differential diagnosis [2,3]
Summary
Wilms tumor (WT) is the most common genitourinary tumor of the children aged between 2-4 years. Clear cell sarcoma (CCS) is one of the mesenchymal tumors of kidney, which is frequently seen in the third year of life. Epithelioid cells with round to oval nucleus form nests and cords. Malignant rhabdoid tumor of kidney is a prominently aggressive tumor, seen among children under 10 years. It is composed of rhabdoid cells that have eosinophilic nucleolus and cytoplasm, big round nucleus, and paranuclear inclusions. These cells are epithelioid, round, and polygonal in appearance and show a solid and trabecular growth pattern [1]. Mesoblastic nephroma, classified into two groups as classical and cellular, is one of the mesenchymal tumors with low potential of malignancy and is seen among children younger than 3 years. Tumor cells form fascicles composed of spindle cells and may resemble infantile fibromatosis
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