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Renal oncocytoma revisited: a clinicopathological study of 109 cases with emphasis on problematic diagnostic features
Author(s) -
Trpkov Kiril,
Yilmaz Asli,
Uzer Dina,
Dishongh Kristin M,
Quick Charles M,
Bismar Tarek A,
Gokden Neriman
Publication year - 2010
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2010.03726.x
Subject(s) - oncocytoma , renal oncocytoma , nuclear atypia , pathology , medicine , coagulative necrosis , clear cell , chromophobe cell , histopathology , adipose capsule of kidney , atypia , kidney , carcinoma , renal cell carcinoma , immunohistochemistry
Trpkov K, Yilmaz A, Uzer D, Dishongh K M, Quick C M, Bismar T A & Gokden N
(2010) Histopathology 57, 893–906 Renal oncocytoma revisited: a clinicopathological study of 109 cases with emphasis on problematic diagnostic featuresAim: To evaluate problematic diagnostic features in renal oncocytoma. Methods and results: One hundred and nine cases of oncocytoma were reviewed and the problematic gross and microscopic features recorded. Multifocal and bilateral neoplasms were found in 12 (11%) and five (4.6%) cases, respectively. Haemorrhage was seen grossly in 30 (27.5%) neoplasms and a central scar was identified in 35 (32.1%). On microscopy, perinephric fat extension was present in 17 (15.6%) neoplasms and vascular extension was identified in four (3.7%) oncocytomas. Rare mitoses and focal coagulative necrosis were identified in two (1.8%) cases each. Focal clear cell changes were found in 16 (14.7%) oncocytomas, typically within hyalinized areas. Limited foci with chromophobe‐like histology (not exceeding 5% of the neoplasm) were found in 13 (11.9%) oncocytomas. In 12 (11%) oncocytomas, rare papillary formations were noted in the lumina of microcysts. Significant nuclear atypia, oncoblasts and entrapped tubules were identified in 27 (24.8%), 41 (37.6%) and 40 (36.7%) neoplasms, respectively. After a median follow‐up of 52 months (range 1–113 months), there was no disease recurrence, progression or death attributed to oncocytoma. Conclusions: The recognition of the spectrum of morphological changes observed in renal oncocytoma should help pathologists establish a diagnosis of oncocytoma in problematic cases.