SECTION II. SPECIFIC TUMORS

Case 7 - Renal Cell Carcinoma, Unclassified




Slide 13 - Short papillae and unclassifiable round cells, low magnification

Slide 14 - Mixture of Wilms'-like epithelium, papillary carcinoma, and high grade carcinoma, high magnification

Click on thumbnail images of slide for an enlarged view

The development of a classification system which reflects, the underlying genetic abnormalities which lead to the phenotype of the neoplasm, requires a diagnostic category to which can be assigned tumors which do not fit into any of the established categories. This is "renal cell carcinoma, unclassified."Any primary renal epithelial malignancy which does not fit into the recognized diagnostic categories belongs in this one. Features which might prompt this diagnosis are shown in the box.  
Renal Cell Carcinoma, Unclassified

Contains morphology not accepted in recognized categories

Apparent composites of recognized types

Sarcomatoid without recognizable epithelial elements

Mucin-producing

Mixtures of epithelial and stromal elements

Unrecognizable cell types


Differential diagnosis: The differential diagnostic possibilities are broad. Metastasis should always be considered when a peculiar-looking carcinoma is found in the kidney. Since a variety of appearances have been ascribed to collecting duct carcinoma, some tumors which we would consider to be renal cell carcinoma, unclassified, would be considered by others to be collecting duct carcinoma. Epithelioid angiomyolipoma (see below) is another differential diagnostic consideration and immunohistochemistry for HMB-45 and actin can be helpful in making this distinction.