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Renal cell carcinoma with rhabdoid features
N Gökden1, O Nappi, P E Swanson
1Lauren V. Ackerman Laboratory of Surgical Pathology, Barnes-Jewish Hospital and the Washington University School of Medicine, St. Louis, MO 63110, USA.
The American Journal of Surgical Pathology
|October 7, 2000
Summary
Rhabdoid features in adult renal cell carcinoma (RCC) are rare but indicate a high-grade, advanced-stage tumor. Identifying these aggressive elements is crucial for diagnosis and distinguishing them from pure rhabdoid tumors.
Area of Science:
- Uropathology
- Oncology
- Cancer Biology
Background:
- Neoplasms with rhabdoid features occur at various sites, but are rare in adult kidneys.
- Renal cell carcinoma (RCC) exhibiting rhabdoid features is poorly understood.
- This study investigates the incidence and characteristics of rhabdoid features in adult RCC.
Purpose of the Study:
- Determine the incidence of rhabdoid features in adult RCC.
- Characterize the histologic, immunophenotypic, and ultrastructural features of these tumors.
- Assess the relationship between rhabdoid features and clinicopathologic parameters like grade and stage.
Main Methods:
- Retrospective analysis of 480 radical nephrectomy specimens for RCC.
- Immunohistochemical evaluation using a panel of antibodies.
- Ultrastructural analysis via electron microscopy in selected cases.
- Correlation of rhabdoid foci with Fuhrman grade and pathologic stage.
Main Results:
- Rhabdoid features were identified in 4.7% (23 of 480) of adult RCC cases.
- Rhabdoid foci were significantly associated with higher Fuhrman grades (p = 3 x 10(-9)) and higher pathologic stages (p = 0.03).
- Immunoreactivity was prominent for vimentin (100%), NSE (79%), and pan-CK (56%), with a distinctive paranuclear pattern.
Conclusions:
- Adult RCC can exhibit rhabdoid components, representing aggressive, high-grade tumors.
- These 'composite' tumors require distinction from pure rhabdoid tumors due to clinicopathologic differences.
- Rhabdoid differentiation may signify clonal evolution and an aggressive tumor element in adult RCC.