Light and Immunohistochemical Characterization of Renal Cell Carcinoma under 40. A Multicenter Study of 114 Cases
JI Lopez, H Garcia, I Anton, A Ugalde, A Banos, JM Onate, J Escandon, V Velasco, JR Vilanova. Hospital de Cruces, Basque Country Univ, Barakaldo, Spain; Hospital 12 de Octubre, Complutensis Univ, Madrid, Spain; Centro POVISA, Vigo, Spain; Hospital de Basurto, Basque Country Univ, Bilbao, Spain; Hospital General Yage, Burgos, Spain; Hospital del Rio Hortega, Valladolid, Spain; Hospital Peset, Valencia Univ, Valencia, Spain
Background: Renal cell carcinoma (RCC) is a rare event in young adults, very few large series being published so far. The aim of this study is to review the histological characteristics and the immunohistochemical profile of a large series of RCC under the age of 40.
Design: A total of 114 cases were collected from 7 hospitals in Spain. Five different categories were considered by light microscopy: Clear cell renal cell carcinoma (CCRCC), papillary renal cell carcinoma (PRCC), chromophobe renal cell carcinoma (ChRCC), clear cell papillary renal cell carcinoma (CCPRCC), biphasic renal cell carcinoma [carcinomas with two different, but clearly recognized, histologies (BRCC)] and unclassified renal cell carcinoma (URCC). Fuhrman's grade was evaluated only in CCRCC. CD10, EMA, CK7, CK20, CD15, CD117, AMACR, CAM 5.2, 34betaE12, e-cadherin, and Melan-A were systematically tested in all cases.
Results: Males predominated (83M/31F), average age of 32,9 years (range, 14-39). Organ confined disease (pT1/2) was observed in 91% of the cases. pN+ status was detected in 2,6% and pM+ in 0,9%. Fuhrman's grade in CCRCC group was G1: 15%, G2: 53%, G3: 23%, G4: 9%.
Histological typing and immunohistochemical profileMost significant markers in CCRCC, PRCC and ChRCC in bold. CCPRCC results in italic. The results of CK20, CD117, 34bE12 and Melan-A were not contributory
|Histology (n)||CD10 (n/%)||EMA (n/%)||CK7 (n/%)||CD15 (n/%)||AMACR (n/%)||CAM 5.2 (n/%)||E-cadh (n/%)|
Conclusions: CCRCC account for only 50% of RCC in this age group, with a significant number of ChRCC and URCC cases. URCC is an odd group with oncocytic changes and high grade features. CCPRCC, a newly proposed entity, represent a relevant proportion of cases and show mixed characteristics between CCRCC and PRCC.
Category: Genitourinary (including renal tumors)
Tuesday, March 10, 2009 9:30 AM
Poster Session III # 108, Tuesday Morning