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renal oncocytoma; renal oxyphilic adenoma
Epidemiology:
- most common in 7th & 8th decade of life [2]
Pathology:
- benign adenomas that arise from collecting tubules [2]
Microscopic Pathology:
- abundant eosinophilic granular cytoplasm
- usually round uniform nuclei, can be some pleomorphism
- Hale colloidal iron stain: negative
- periodic acid Schiff: negative
Clinical manifestations:
- generally incidental finding
Laboratory:
Immunocytochemistry:
- vimentin: negative
- band 3 anion exchange protein: positive
- CK7: negative
- low molecular weight cytokeratin: positive
- cytokeratin AE1/AE3: positive
- carbonic anhydrase: positive
- CD10: -/+
- RCC antibody: negative
Radiology:
- CT of kidneys
- solid mass with central stellate scar [2]
- imaging alone insufficient for distinguishing renal oncocytoma from renal cell carcinoma
- CT-guided core-needle biopsy often insufficient as well
Differential diagnosis:
- renal cell carcinoma, chromophobe type (CK7: +, band 3 anion exchange protein: -)
- renal cell carcinoma, clear cell type (vimentin: +, band 3 anion exchange protein: -, CD10: +, RCC antibody: +
Management:
- surgical resection generally required for diagnosis
Interactions
disease interactions
General
kidney neoplasm
oncocytoma (oxyphilic adenoma)
References
- Dabbs. Diagnostic Immunohistochemistry. Churchill-Livingstone,
2002. page 480.
- Thomas S, Grimm L, Brady MP
Renal Cell Carcinoma: Recognition and Follow-up.
Medscape. April 18, 2016
http://reference.medscape.com/features/slideshow/renal-cell-carcinoma