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- Histologic Variations and Immunohistochemical Features of Metastatic Clear Cell Renal Cell Carcinoma
- Cheol Lee, Jeong-Whan Park, Ja Hee Suh, Kyung Han Nam, Kyung Chul Moon
- Korean J Pathol. 2013;47(5):426-432. Published online October 25, 2013
- DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.5.426
- 8,775 View
- 74 Download
- 16 Crossref
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Abstract
PDF Background Due to advancements in treatment of metastatic and advanced renal cell carcinoma (RCC), it has become increasingly important to diagnose metastatic RCC and the specific subtype. In this study, we investigated the diverse histologic features of metastatic clear cell renal cell carcinoma (CCRCC) cases in comparison with corresponding primary lesions.
Methods We identified 119 metastatic CCRCC cases from 81 corresponding primary lesions diagnosed between 1995 and 2010 and evaluated the diverse histologic and immunohistochemical features of these lesions.
Results A total of 44 primary lesions (54.3%) had a non-clear cell component in addition to a typical clear cell component. Of the 119 metastatic lesions, 63 lesions (52.9%) contained a non-clear cell component, and 29 metastatic lesions were composed of a non-clear cell component only. Rhabdoid features were the most frequent non-clear cell histology among the metastatic lesions. Metastatic CCRCCs mainly showed positive CD10 and epithelial membrane antigen staining and negative cytokeratin 7 staining.
Conclusions Metastatic CCRCC commonly showed a variety of histologic features. If there is a difficulty to diagnose metastatic CCRCC due to a variety of histologic features or small biopsy specimen, histologic review of the primary lesion and immunohistochemical analysis can help determine the correct diagnosis.
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Citations
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- ERG Immunohistochemistry and Clinicopathologic Characteristics in Korean Prostate Adenocarcinoma Patients
- Ja Hee Suh, Jeong-Whan Park, Cheol Lee, Kyung Chul Moon
- Korean J Pathol. 2012;46(5):423-428. Published online October 25, 2012
- DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.5.423
- 7,561 View
- 33 Download
- 17 Crossref
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Abstract
PDF
Background Transmembrane protease serine 2-ETS related gene (
TMPRSS2-ERG ) gene fusion, the most common genetic alternation in prostate cancer, is associated with protein expression of the oncogeneERG . Recently, an immunohistochemical staining method using an anti-ERG antibody was shown to have a strong correlation with altered ERG protein expression.Methods We analyzed a total of 303 radical prostatectomy specimens (obtained from Korean prostate cancer cases) using a constructed tissue microarray and ERG immunohistochemical staining. Thereafter, we evaluated the association between ERG expression and clinicopathological factors.
Results The ERG-positive rate was 24.4% (74/303) and significantly higher ERG expression was observed in the subgroup with a lower Gleason score (p=0.004). Analysis of the histologic pattern of prostate adenocarcinomas revealed that tumors with discrete glandular units (Gleason pattern 3) displayed higher frequency of ERG expression (p=0.016). The ERG-positive rate was lower than that found (approximately 50%) in studies involving western populations. Other factors including age, tumor volume, initial protein-specific antigen level, a pathological stage and margin status were not significantly related with the ERG expression.
Conclusions ERG immunohistochemical staining is significantly higher in tumors with well-formed glands and is associated with a lower Gleason score.
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