Clear cell renal cell carcinoma of the kidney

Immunohistochemistry

Usually coexpress pancytokeratin and vimentin, unlike most other carcinomas. Most are EMA positive but negative for CEA and for both CK7 and CK2011. However, there is considerable overlap with other tumours which constitute differentials of renal cell carcinoma. The "Renal cell carcinoma marker" has a promising specificity for renal cell carcinoma.

Differential diagnosis of metastatic clear cell renal cell carcinoma10:

metastatic renal carcinoma:

coexpression of cytokeratin and vimentin

versus

most other carcinomas:

cytokeratin positive, vimentin negative

metastasis to adrenal:

EMA positive, cytokeratin positive

versus

primary adrenal cortical carcinoma:

EMA negative, only weakly cytokeratin positive.

metastasis to thyroid

thyroglobulin negative

versus

primary clear cell carcinoma of thyroid:

thyroglobulin positive

metastasis to brain:

EMA positive

versus

primary capillary haemangioblastoma or CNS:

EMA negative

Predominantly eosinophilic primary renal cell tumours:

	clear cell renal cell carcinoma, eosinophilic variant	oncocytoma	chromophobe renal cell carcinoma
vimentin	positive	negative	negative
CD10	positive	variable	negative
RCC marker	positive	negative	variable
CK7	negative	variable	positive
mitochondria	diffuse	peripheral	peripheral
proliferation index (MIB-1)	often >2%	<2%	<2%

References

This page last revised 19.12.2001.