Chromophobe Renal Cell Carcinoma Diagnosis

A chromophobe renal cell carcinoma shows a number of histologic and molecular features.

Gross appearance: well-circumscribed, gray to black to brown to tan to yellow

Routine histology:

(1) usual cell types: eosinophilic or pale

(2) less common cell types: sarcomatoid

(3) patterns: alveolar, nested, sheetlike

(4) Nuclei vary from round with uniform chromatin to wrinkled with dense chromatin.

(5) Binucleated or multinucleated cells are relatively common.

(6) The mitotic rate is usually low except in sarcomatoid areas.

(7) A zone of perinuclear clearing is often present.

Special Study	Finding
Hale's colloidal iron	diffuse and granular
immunostain for parvalbumin	positive
immunostains for low molecular weight keratin (CAM 5.2, AE1)	positive
immunostain for high molecular weight keratin	negative
immunostain for EMA	positive
immunostain for vimentin	negative
immunostain for CD9	positive
electron microscopy	numerous cytoplasmic microvesicles and mitochondria
genetic analysis	hypodiploid with loss of 1 or more chromosomes (1, 2, 6, 10, 13, 17, 21, Y)

Differential diagnosis:

(1) oncocytoma

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Diagnostic Features of a Chromophobe Renal Cell Carcinoma