Differential diagnosis of renal tumors with clear cytoplasm: Clinical relevance of renal tumor subclassification in the era of targeted therapies and personalized medicine

Rajen Goyal, Elizabeth Gersbach, Ximing J. Yang, Stephen M. Rohan*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

30 Scopus citations

Abstract

Context. - The World Health Organization classification of renal tumors synthesizes morphologic, immunohistochemical, and molecular findings to define more than 40 tumor types. Of these, clear cell (conventional) renal cell carcinoma is the most common malignant tumor in adults and - with the exception of some rare tumors - the most deadly. The diagnosis of clear cell renal cell carcinoma on morphologic grounds alone is generally straightforward, but challenging cases are not infrequent. A misdiagnosis of clear cell renal cell carcinoma has clinical consequences, particularly in the current era of targeted therapies. Objective. - To highlight morphologic mimics of clear cell renal cell carcinoma and provide strategies to help differentiate clear cell renal cell carcinoma from other renal tumors and lesions. The role of the pathologist in guiding treatment for renal malignancies will be emphasized to stress the importance of proper tumor classification in patient management. Data Sources. - Published literature and personal experience. Conclusions. - In challenging cases, submission of additional tissue is often an inexpensive and effective way to facilitate a correct diagnosis. If immunohistochemical stains are to be used, it is best to use a panel of markers, as no one marker is specific for a given renal tumor subtype. Selection of limited markers, based on a specific differential diagnosis, can be as useful as a large panel in reaching a definitive diagnosis. For renal tumors, both the presence and absence of immunoreactivity and the pattern of labeling (membranous, cytoplasmic, diffuse, focal) are important when interpreting the results of immunohistochemical stains.

Original languageEnglish (US)
Pages (from-to)467-480
Number of pages14
JournalArchives of Pathology and Laboratory Medicine
Volume137
Issue number4
DOIs
StatePublished - Apr 2013

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Fingerprint

Dive into the research topics of 'Differential diagnosis of renal tumors with clear cytoplasm: Clinical relevance of renal tumor subclassification in the era of targeted therapies and personalized medicine'. Together they form a unique fingerprint.

Cite this