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Chromophobe renal call carcinoma with neuroendocrine and neuroendocrine-like features. Morphologic, immunohistochemical, ultrastructural, and array comparative genomic hybridization analysis of 18 cases and review of the literature

Chromophobe renal cell carcinoma (CRCC) with neuroendocrine differentiation (CRCCND) has only recently been described. Eighteen cases of CRCC with morphologic features suggestive of neuroendocrine differentiation were selected from among 624 CRCCs in our registry. The tissues were fixed in neutral formalin, embedded in paraffin, cut into 4- to 5-μm-thick sections, and stained with hematoxylin and eosin. As CRCC with neuroendocrine features, tumors with following morphology were suggested: (1) trabecular/palisading/ribbon-like, gyriform, insular, glandular, and solid pattern; (2) uniform polygonal cells formed in small islets; and (3) cribriform pattern in combination with palisading. Selected cases were further analyzed using immunohistochemistry, electron microscopy, array comparative genomic hybridization, and fluorescence in situ hybridization. Cases were classified as CRCCND or CRCC with neuroendocrine-like features (CRCCND-L) based on the immunohistochemical expression of neuroendocrine markers: CRCCND, 4 cases, age range 49 to 79 years, size ranged from 2.2 to 22 cm, and CRCCND-L, 14 cases, age range 34 to 74 years, size range 3.8 to 16.5 cm. Follow-up information was available for 11 of 18 patients aged 0.5 to 12 years. Two of 4 CRCCNDs showed aggressive clinical course with metastatic spreading. Chromophobe renal cell carcinomas with neuroendocrine differentiation were focally positive for CD56 (4/4), synaptophysin (4/4), chromogranin A (1/4), and neuron-specific enolase (3/4). All 14 CRCCND-Ls were mostly negative or very weakly focally positive for some of the aforementioned markers. All 18 tumors were positive for cytokeratin 7 and CD117. Ultrastructural analysis showed poorly preserved neuroendocrine granules only in 2 of 4 analyzed CRCCNDs. Losses of chromosomes 1, 2, 6, and 10 were found in all analyzable CRCCNDs, whereas multiple losses (chromosomes 1, 2, 6, 10, 13, 17, and 21) and gains (chromosomes 4, 11, 12, 14, 15, 16, 19, and 20) were found in CRCCND-L.

Credits:

Peckova K1, Martinek P1, Ohe C2, Kuroda N3, Bulimbasic S4, Condom Mundo E5, Perez Montiel D6, Lopez JI7, Daum O1, Rotterova P1, Kokoskova B1, Dubova M1, Pivovarcikova K1, Bauleth K1, Grossmann P1, Hora M8, Kalusova K8, Davidson W9, Slouka D10, Miroslav S11, Buzrla P12, Hynek M13, Michal M1, Hes O14.

  • 1. Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Plzen, Czech Republic.
  • 2. Department of Diagnostic Pathology, Kansai Medical University, Hirakata Hospital, Osaka, Japan.
  • 3. Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi, Japan.
  • 4. Department of Pathology, University Hospital Dubrava, Zagreb, Croatia.
  • 5. Department of Pathology, Bellvitge University Hospital, Barcelona, Spain.
  • 6. Department of Pathology, Instituto Nacional de Cancerologia, Mexico City, Mexico.
  • 7. Department of Pathology, Cruces University Hospital, Barakaldo, Spain.
  • 8. Department of Urology, Charles University, Medical Faculty and Charles University Hospital Plzen, Plzen, Czech Republic.
  • 9. Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS.
  • 10. Department of Otorhinolaryngology, Charles University, Medical Faculty and Charles University Hospital Plzen, Plzen, Czech Republic.
  • 11. Bioptical Laboratory Chomutov, Chomutov, Czech Republic.
  • 12. Department of Pathology, University Hospital Ostrava, Ostrava, Czech Republic.
  • 13. Department of Radiology, Medical Faculty and Charles University Hospital Plzen, Plzen, Czech Republic.
  • 14. Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Plzen, Czech Republic; Biomedical Centre, Charles University, Medical Faculty and Charles University Hospital Plzen, Plzen, Czech Republic.

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