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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/19 19:49:04」(JST)

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Renal oncocytoma of the right kidney at CT.

A renal oncocytoma is a tumour of the kidney made up of oncocytes, a special kind of cell.^[1]^[2]

Signs and symptoms

Renal oncocytomas are often asymptomatic and are frequently discovered by chance on a CT or ultrasound of the abdomen. Possible signs and symptoms of a renal oncocytoma include blood in the urine, flank pain, and an abdominal mass.

Pathophysiology

Renal oncocytoma is thought to arise from the intercalated cells of collecting ducts of the kidney. It represent 5% to 15% of surgically resected renal neoplasms. Ultrastructurally, the eosinophilic cells have numerous mitochondria.

Histologic appearance

An oncocytoma is an epithelial tumor composed of oncocytes, large eosinophilic cells having small, round, benign-appearing nuclei with large nucleoli with excessive amounts of mitochondria.

Diagnosis

Gross appearance of a renal oncocytoma (left of image) and a slice of a normal kidney (right of image). Note the rounded contour, the mahogany colour and the central scar.

In gross appearance, the tumors are tan or mahogany brown, well circumscribed and contain a central scar. They may achieve a large size (up to 12 cm in diameter).

The main differential diagnosis of renal oncocytoma is chromophobe renal cell carcinoma oncocytic variant, which like the renal oncocytoma has eosinophilic cytoplasm, but has perinuclear clearing and, typically, some degree of nuclear atypia.

Immunohistochemical profile

Cytokeratin AE1/AE3 +
Vimentin -
EMA +
CD10+/-
CK7 +/- parcellaire
CK20 -
CK19 -
AMACR (Racemase) -
S100 +
c-kit (CD117) +
Cadherin-E +
TFE3 -
CAM5.2 +

^[3]

Treatment

Renal oncocytoma is considered benign, cured by nephrectomy. There are some familial cases in which these tumors are multicentric rather than solitary.^[4] However, they may be resected to exclude a malignant tumor, e.g. renal cell carcinoma.

Additional images

Micrograph of a renal oncocytoma. H&E stain.
Micrograph of a renal oncocytoma. H&E stain.
Micrograph of a renal oncocytoma. H&E stain.
Micrograph of a renal oncocytoma. H&E stain.
Micrograph of a renal oncocytoma. H&E stain.
Micrograph of chromophobe RCC oncocytic variant, the main differential diagnosis of renal oncocytoma.

References

^ Coburn V, Radfar A, Snook D, Mahalingam M (2007). "Cutaneous oncocytoma - a report of three cases and review of the literature". J. Cutan. Pathol. 34 (4): 355–9. doi:10.1111/j.1600-0560.2006.00620.x. PMID 17381809.
^ "Atlas of Genetics and Cytogenetics in Oncology and Haematology - Thyroid:oncocytic tumors". Retrieved 2009-02-01.
^ [Renal Neoplasms: An Update on Immunohistochemical and Histochemical Features http://www.dako.com/08066_12may10_webchapter26.pdf]
^ Robbins pathology, page 1015^{[full citation needed]}

UpToDate Contents

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1. 腎細胞癌の疫学、病理、および病因 epidemiology pathology and pathogenesis of renal cell carcinoma
2. 腎の小腫瘤の診断的アプローチ、鑑別診断、および治療 diagnostic approach differential diagnosis and treatment of a small renal mass
3. 結節性硬化症の腎症状 renal manifestations of tuberous sclerosis complex
4. 腎血管筋脂肪腫 renal angiomyolipomas
5. 慢性苔癬状粃糠疹 pityriasis lichenoides chronica

English Journal

Renal cell carcinoma and mimics: pathologic primer for radiologists.

Bai X, Wu CL.SourceDivision of Nephrology, Nanfang Hospital, Southern Medical University and Guangdong Provincial Institute of Nephrology, Guangzhou, Guangdong, China.
AJR. American journal of roentgenology.AJR Am J Roentgenol.2012 Jun;198(6):1289-93.
OBJECTIVE: The purpose of this article is to present a primer to review the gross and microscopic characteristics of the common types of renal cell carcinoma (RCC), such as clear cell RCC, papillary RCC, and chromophobe RCC. Renal oncocytoma and several new and emerging types of RCC are also describ
PMID 22623540

Renal cell carcinoma with extensive oncocytic features.

Moghadamfalahi M, Alatassi H.Source1University of Louisville, Louisville, KY, USA.
International journal of surgical pathology.Int J Surg Pathol.2012 Jun;20(3):269-71. Epub 2011 Sep 8.
Oncocytic features are a hallmark of renal oncocytoma, but can be seen in other renal tumors such as clear cell renal cell carcinoma with granular cells and eosinophilic variant of chromophobe cell tumors. Up to 5% of renal neoplasms are ultimately diagnosed as unclassified renal cell carcinoma with
PMID 21903682

Japanese Journal

Immunohistochemical application of S100A1 in renal oncocytoma, oncocytic papillary renal cell carcinoma, and two variants of chromophobe renal cell carcinoma

KURODA Naoto,KANOMATA Naoki,YAMAGUCHI Tadanori,IMAMURA Yoshiaki,OHE Chisato,SAKAIDA Noriko,HES Ondrej,MICHAL Michal,SHUIN Taro,LEE Gang-Hong
Medical molecular morphology : official journal of the Japanese Society for Clinical Molecular Morphology 44(2), 111-115, 2011-06-01
NAID 10029036907