Renal cell carcinoma marker (RCC Ma)

This monoclonal antibody has been raised against a 200 kD glycoprotein found in the renal proximal tubular brush border. It is immunoreactive with formalin-fixed, paraffin-embedded tissues. It has a high specificity for renal cell carcinoma: breast is the most important other primary site from which immunoreactive tumours may arise. Its sensitivity is higher for primary (80%) than metastatic (67%) renal cell carcinoma.

Some authors find the staining capricious and unreliable².

Immunohistochemical expression

• Positive in proximal rather than distal normal renal tubules³.

primary renal cell carcinoma	clear cell	59/70(solid 56/62, cystic 3/8), 5/6 (granular [eosinophilic] variant: the negative case was Fuhrman grade IV)4
	papillary	56/58 (papillary adenoma 4/4, papillary carcinoma 52/54)
	chromophobe	5/11 (typical variant 5/8, eosinophilic variant 0/3), 0/114
	sarcomatoid	2/9
	collecting duct	0/9
	overall	122/153 (80%)
metastatic renal cell carcinoma		42/63 (67%)
other primary renal tumours		0/64 (oncocytoma 0/15, transitional cell carcinoma 0/20, mesoblastic nephroma 0/3, cystic nephoma 0/3, lymphoma 0/8, angiomyolipoma 0/3, mixed stromal and epithelial tumour 0/4, nephroblastoma 0/8) , 0/12(oncocytoma)4
non-renal primary tumours	breast	5/15   invasive ductal carcinoma 2/10 invasive lobular carcinoma 1/2 mucinous carcinoma 0/3 ductal papilloma 1/1 phyllodes tumour 1/1
	parathyroid adenoma	8/8
	testicular embryonal carcinoma	2/7
	others	0/116   adrenocortical adenoma 0/6 adrenocortical carcinoma 0/7 ovarian carcinoma 0/8 lung carcinomas 0/4 colonic adenocarcinoma 0/7 pancreatic carcinoma 0/3 pancreatic islet cell tumour 0/4 hepatocellular carcinoma 0/21 thyroid carcinomas 0/10 thymic carcinomas 0/6 yolk sac carcinoma 0/4 seminoma 0/3 teratoma 0/2 cerebral haemangioma 0/5 carcinoid 0/1 lymphoma 0/9 liposarcoma 0/3 MFH 0/2 chondrosarcoma 0/1
non-renal metastatic carcinomas	breast	2/19
	other	0/89   colon 0/21 lung 0/19 ovary 0/23 stomach 0/11 pancreatic / ampullary 0/9 prostate 0/2 melanoma 0/2

Diagnostic utility

• Differentiating primary or metastatic renal cell carcinoma from non-renal tumour

• The differential diagnosis of eosinophilic renal tumours: granular variant of renal cell carcinoma, chromophobe renal cell carcinoma and oncocytoma.

References

¹ McGregor, D. K., Khurana, K. K., Cao, C. Diagnosing primary and metastatic renal cell carcinoma: the use of the monoclonal antibody 'Renal Cell Carcinoma Marker'. Am J Surg Pathol 2001;25:1485-1492.

² Abrahams, N. A., G. T. Maclennan, et al. (2004). "Chromophobe renal cell carcinoma: a comparative study of histological, immunohistochemical and ultrastructural features using high throughput tissue microarray." Histopathology 45(6): 593-602.

³ Pan, C. C., P. C. Chen, et al. (2004). "The diagnostic utility of MOC31, BerEP4, RCC marker and CD10 in the classification of renal cell carcinoma and renal oncocytoma: an immunohistochemical analysis of 328 cases." Histopathology 45(5): 452-9.

⁴ Wang HY,Mills SE. KIT and RCC are useful in distinguishing chromophobe renal cell carcinoma from the granular variant of clear cell renal cell carcinoma. Am J Surg Pathol 2005; 29:640-6

This page last revised 17.7.2005.

©SMUHT/PW Bishop