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Int J Clin Exp Pathol 2011;4(7):708-712

Case Report
Small oncocytic papillary renal cell carcinoma in diabetic glomerulosclerosis

Tadashi Terada

Departments of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan

Received August 13, 2011; accepted October 9, 2011; Epub October 16, 2011; published October 31, 2011

Abstract: Histologic and immunohistochemical features of oncocytic papillary renal cell carcinoma (RCC) have not been fully elucidated. The
author herein report a case of oncocytic papillary RCC (OPRCC). A 71-year-old man with diabetes mellitus and diabetic nephropathy was found
to have a small right renal tumor by CT. He had been treated with hemodialysis for chronic renal failure for 10 years. A nephrectomy was
performed. Grossly, a small (1.5cm) encapsulated yellow tumor was found in the kidney. Histologically, the tumor was completely
encapsulated, and consisted entirely of atypical oncocytes arranged in a diffuse papillary structure with fibrovascular cores. The oncocytes
showed grade  3 atypia and pseudostratification. A few mitotic figures were seen, and psammoma bodies, formy macrophages, and
hemosiderin were scattered. Histochemically, the tumor cells were positive for colloidal iron, and negative for mucins (alcian blue/PAS).  
Immunohistochemical results of the tumor were as follows: α-methylacyl-coenzyme A rasemase (AMACR) +++, vimentin +++, cytokeratin (CK)
18 +++, CD10 +++, S-100 protein +, MUC1 ++, MUC2 ++, MUC5AC ++, MUC6 ++, panCK Cam5.2 +, CK7 +, CK8 +, CK14 +, CK19 +, CK20 +,
p53 +, HepPar1 +, CD68 +, platelet-derived growth factor-α (PDGFRA) +, PanCK AE1/3 -, PanCK WSS -, PanCK MNF115 -, CK 35BE12 -, CK5/6 -
, EMA -, desmin -, smooth muscle antigen -, α-fetoprotein -, CEA -, estrogen receptor -, progesterone receptor -, HER2 -, p63 -, and KIT -.  Ki67
labeling was 6%. These results suggest that OPRCC can express colloidal iron, low molecular weight CKs, S100 protein, MUC1, MUC2,
MUC5AC, MUC6, p53, PDGFRA, and HepPar1.. (IJCEP1108010).

Keywords: Oncocytic papillary RCC, immunohistochemistry

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Address all correspondence to:
Tadashi Terada, MD, PhD
Department of Pathology, Shizuoka City Shimizu Hospital
Miyakami 1231, Shimizu-Ku, Shizuoka, 424-8636, Japan.
Tel: 81-54-336-1111; Fax: 81-54-336-1315
E-mail: piyo0111jp@yahoo.co.jp