New emerging entities: renal tumors described after WHO Classification 2016
Authors:
Ondřej Hes 1; Milan Hora 2; Tomáš Pitra 2; Monika Šedivcová 1; Jiří Kolář 2; Adriana Veselá 2; Ondřej Fiala 3
Authors place of work:
Šiklův ústav patologie, Lékařská fakulta Plzeň, Univerzita Karlova a Fakultní nemocnice Plzeň
1; Urologická klinika, Lékařská fakulta Plzeň, Univerzita Karlova a Fakultní nemocnice Plzeň
2; Onkologická a radioterapeutická klinika, Lékařská fakulta Plzeň, Univerzita Karlova a Fakultní nemocnice Plzeň
3
Published in the journal:
Ces Urol 2020; 24(3): 183-190
Category:
Review article
Summary
Hes O, Hora M, Pitra T, Šedivcová M, Kolář J, Veselá A, Fiala O. New emerging entities: renal tumors described after WHO Classification 2016.
Histopathological Classification of renal tumors is more complicated every year. New emerging entities are defined not only by morphology and immunohistochemical profile, but also more frequently using molecular genetic techniques.
In this review, new perspective entities with clearly defined molecular‑genetic background are introduced. Groups of renal tumors sharing abnormalities in the mTOR pathway were recognized recently. It is eosinophilic solid and cystic renal cell carcinoma, high grade oncocytic tumor, and low grade oncocytic tumor. All subtypes follow an indolent non aggressive course despite presence of high‑grade nuclei.
MitF related renal cell carcinomas (translocation) renal cell carcinomas were listed in WHO classification since 2004. New member of RCC with impaired TFEB gene is renal cell carcinoma with TFEB amplification. This subtype is aggressive (contrary to TFEB translocated RCC) and very difficult to diagnose.
Several other entities are intensively studied and examined. Their current status is questionable and more likely they will not be listed in upcoming WHO classification. Despite the rapid progression in diagnostic abilities, practical impact for routine clinical practice is (in 2020) limited.
Conclusions: Urologists and oncologists should expect new, relatively complicated classification of renal tumors, partly based on molecular genetic features. However, a more personalized approach to individual patients is desirable, clinical specialists do not dispose appropriate spectrum of systemic treatment modalities.
Keywords:
kidney – Renal cell carcinoma – new entities – molecu‑ lar genetic diagnosis
Zdroje
1. Hora M, Hes O. Histologie nádorů ledvin dospělých. Ces Urol 1998; 2: 29–32.
2. Hora M, Ürge T, Kalusová K, et al. Novelizovaná klasifikace nádorů ledvin 2013 (International society of urological pathology vancouver classification of renal neoplasia). Ces Urol 2014; 18: 9–20.
3. Moch H, Humphrey PA, Ulbright TM, VE R. WHO Classification of Tumours of the Urinary System and Organs. IARC Lyon 2016.
4. Ljungberg BAL, Bensalah K, Bex (Vice‑chair) A, et al. EAU guidelines on renal cell carcinoma. https:// uroweb.org/guideline/renal‑cell‑carcinoma/, ISBN 978-94-92671-07-3 2020.
5. Kolář J, Pitra T, Pivovarčíková K, et al. Hereditární renální nádorové syndromy. Ces Urol 2020; 24: 26–41.
6. Guo J, Tretiakova MS, Troxell ML, et al. Tuberous sclerosis‑associated renal cell carcinoma: a clinicopathologic study of 57 separate carcinomas in 18 patients. Am J Surg Path 2014; 38; 1457–1467.
7. Yang P, Cornejo KM, Sadow PM, et al. Renal cell carcinoma in tuberous sclerosis complex. Am J Surg Path 2014; 38: 895–909.
8. Trpkov K, Hes O, Bonert M, et al. Eosinophilic, solid, and cystic renal cell carcinoma: clinicopathologic study of 16 unique, sporadic neoplasms occurring in women. Am J Surg Path 2016; 40: 60–71.
9. Palsgrove DN, Li Y, Pratilas CA, et al. Eosinophilic solid and cystic (ESC) renal cell carcinomas harbor TSC mutations: molecular analysis supports an expanding clinicopathologic spectrum. Am J Surg Path 2018; 42: 1166–1181.
10. Hes H, Trpkov K, Martinek P, et al. „High‑grade oncocytic renal tumor“: morphologic, immunohistochemical, and molecular genetic study of 14 cases. Virchows Arch.: an international journal of pathology 2018; 473: 725–738.
11. Chen YB, Mirsadraei L, Jayakumaran G, et al. Somatic mutations of TSC2 or mtor characterize a morphologically distinct subset of sporadic renal cell carcinoma with eosinophilic and vacuolated cytoplasm. Am J Surg Path 2019; 43: 121–131.
12. Trpkov K, Bonert M, Gao Y, et al. High‑grade oncocytic tumour (HOT) of kidney in a patient with tuberous sclerosis complex. Histopathology 2019; 75: 440–442.
13. Farcas M, Gatalica Z, Swensen J, et al. High‑grade oncocytic tumor (HOT) of kidney is characterized by frequent TSC1, TSC2 and mtor mutations – a further characterization of an emerging entity. Lab Invest 2020; 10: 885.
14. Trpkov K, Williamson SR, Gao Y, et al. Low‑grade oncocytic tumour of kidney (cd117-negative, cytokeratin 7-positive): A distinct entity? Histopathology 2019; 75: 174–184.
15. Shah RB, Stohr BA, Tu ZJ, et al. „Renal cell carcinoma with leiomyomatous stroma“ harbor somatic mutations of TSC1, TSC2, MTOR, and/or ELOC (TCEB1): clinicopathologic and molecular characterization of 18 sporadic tumors supports a distinct entity. The American Journal of Surgical Pathology 2020; 44(5): 571–581.
16. Trpkov K, Hes O. New and emerging renal entities: a perspective post‑who 2016 classification. Histopathology 2019; 74: 31–59.
17. Kuroda N, Trpkov K, Gao Y, et al. Alk rearranged renal cell carcinoma (ALK-RCC): a multi‑institutional study of twelve cases with identification of novel partner genes clip1, kif5b and kiaa1217. Mod Pathol: an official journal of the United States and Canadian Academy of Pathology, Inc 2020. Online ahead of print.
18. Peckova K, Vanecek T, Martinek P, et al. Aggressive and nonaggressive translocation t(6; 11) renal cell carcino‑ ma: Comparative study of 6 cases and review of the literature. Annals of Diagnostic Pathology 2014; 18: 351–357.
19. Argani P, Reuter VE, Zhang L, et al. Tfeb‑amplified renal cell carcinomas: an aggressive molecular subset demonstrating variable melanocytic marker expression and morphologic heterogeneity. The American Journal of Surgical Pathology 2016; 40: 1484–1495.
20. Williamson SR, Grignon DJ, Cheng L, et al. Renal cell carcinoma with chromosome 6p amplification including the tfeb gene: a novel mechanism of tumor pathogenesis? The American Journal of Surgical Pathology 2017; 41: 287–298.
21. Skala SL, Xiao H, Udager AM, et al. Detection of 6 tfeb‑amplified renal cell carcinomas and 25 renal cell carcinomas with mitf translocations: Systematic morphologic analysis of 85 cases evaluated by clinical tfe3 and tfeb fish assays. Modern Pathology: an official journal of the United States and Canadian Academy of Pathology, Inc 2018; 31: 179–197.
Štítky
Paediatric urologist Nephrology UrologyČlánok vyšiel v časopise
Czech Urology
2020 Číslo 3
Najčítanejšie v tomto čísle
- Minimally invasive surgical methods for the treatment of benign prostatic hyperplasia, as an alternative to classic desobstructive procedures
- Prevention of recurrent cystitis with intravesical instillation of hyaluronic acid Flaveran®
- Prostate carcinoma metastasis to the testis
- Bladder neck preservation with RARP