腎膨大細胞腫、腎オンコサイトーマ
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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 |
Micrograph of a renal oncocytoma.
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Classification and external resources |
ICD-O |
M8290/0 |
DiseasesDB |
31956 |
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]
Contents
- 1 Signs and symptoms
- 2 Pathophysiology
- 2.1 Histologic appearance
- 3 Diagnosis
- 3.1 Immunohistochemical profile
- 4 Treatment
- 5 See also
- 6 Additional images
- 7 References
Signs and symptoms
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This section requires expansion. (January 2011) |
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
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This section requires expansion. (January 2011) |
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.
See also
- Kidney
- Renal cell carcinoma
Additional images
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Micrograph of a renal oncocytoma. H&E stain.
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Micrograph of a renal oncocytoma. H&E stain.
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Micrograph of a renal oncocytoma. H&E stain.
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Micrograph of a renal oncocytoma. H&E stain.
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Micrograph of a renal oncocytoma. H&E stain.
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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]
Glandular and epithelial neoplasms (ICD-O 8010-8589)
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Epithelium |
Papilloma/carcinoma
(8010-8139) |
- Small cell carcinoma
- Combined small cell carcinoma
- Verrucous carcinoma
- Squamous cell carcinoma
- Basal cell carcinoma
- Transitional cell carcinoma
- Inverted papilloma
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Glands |
Adenomas/
adenocarcinomas
(8140-8429) |
Gastrointestinal |
- tract: Linitis plastica
- Familial adenomatous polyposis
- pancreas
- Insulinoma
- Glucagonoma
- Gastrinoma
- VIPoma
- Somatostatinoma
- Cholangiocarcinoma
- Klatskin tumor
- Hepatocellular adenoma/Hepatocellular carcinoma
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Urogenital |
- Renal cell carcinoma
- Endometrioid tumor
- Renal oncocytoma
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Endocrine |
- Prolactinoma
- Multiple endocrine neoplasia
- Adrenocortical adenoma/Adrenocortical carcinoma
- Hurthle cell
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Other/multiple |
- Neuroendocrine tumor
- Adenoid cystic carcinoma
- Oncocytoma
- Clear cell adenocarcinoma
- Apudoma
- Cylindroma
- Papillary hidradenoma
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Adnexal and
skin appendage (8390-8429) |
- sweat gland
- Syringocystadenoma papilliferum
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Cystic, mucinous,
and serous (8440-8499) |
Cystic general |
- Cystadenoma/Cystadenocarcinoma
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Mucinous |
- Signet ring cell carcinoma
- Mucinous cystadenoma / Mucinous cystadenocarcinoma
- Mucoepidermoid carcinoma
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Serous |
- Ovarian serous cystadenoma / Pancreatic serous cystadenoma / Serous cystadenocarcinoma / Papillary serous cystadenocarcinoma
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Ductal, lobular,
and medullary (8500-8549) |
Ductal carcinoma |
- Mammary ductal carcinoma
- Pancreatic ductal carcinoma
- Comedocarcinoma
- Paget's disease of the breast / Extramammary Paget's disease
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Lobular carcinoma |
- Lobular carcinoma in situ
- Invasive lobular carcinoma
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Medullary carcinoma |
- Medullary carcinoma of the breast
- Medullary thyroid cancer
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Acinar cell (8550-8559) |
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Other |
Complex epithelial (8560-8589) |
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- See also
- Template:Epithelium and epithelial tissue
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Tumors: urogenital neoplasia: urinary organs (C64–C68/D30, 188–189/223)
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Abdominal |
Kidney |
Glandular and epithelial neoplasm: |
- Renal cell carcinoma
- Renal oncocytoma
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Complex and mixed tumor: |
- Wilms' tumor
- Mesoblastic nephroma
- Clear-cell sarcoma of the kidney
- Angiomyolipoma
- Cystic nephroma
- Metanephric adenoma
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by location: |
- Renal medullary carcinoma
- Juxtaglomerular cell tumor
- Renal medullary fibroma
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Ureter |
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Pelvic |
Bladder |
- Transitional cell carcinoma
- Inverted papilloma
- Squamous-cell carcinoma
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Urethra |
- Transitional cell carcinoma
- Squamous-cell carcinoma
- Adenocarcinoma
- Melanoma
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Retroperitoneum |
- Malignant fibrous histiocytoma
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Index of the urinary system
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Description |
- Anatomy
- Physiology
- Development
- Cells
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Disease |
- Electrolyte and acid-base
- Congenital
- Neoplasms and cancer
- Other
- Symptoms and signs
- Urine tests
- Blood tests
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Treatment |
- Procedures
- Drugs
- Intravenous fluids
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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
- Renal mass sampling : An enlightened perspective
- SAMPLASKI Mary K,ZHOU Ming,LANE Brian R,HERTS Brian,CAMPBELL Steve C
- International journal of urology 18(1), 5-19, 2011-01-01
- NAID 10027901630
Related Links
- Renal oncocytoma is a type of relatively benign renal tumour. The main clinical importance of this lesion is the difficulty in pre-operatively distinguishing it from renal cell carcinomas, as epidemiology, presentation, imaging and even ...
- Oncocytoma is the most common benign solid renal tumor (see the images below). First described by Zippel in 1942, this tumor represents a distinct pathologic entity. ... Epidemiology In most reviews, oncocytomas ...
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