Clear Cell Renal Cell Carcinoma
Differential Diagnosis
| Conventional Clear Cell Renal Cell Carcinoma |
Chromophobe Renal Cell Carcinoma |
| Sheets and nests of clear cells with prominent surrounding vascular network |
Rigid cell membranes, central nuclei with surrounding nuclear clearing |
| CD117/KIT neg |
CD117/KIT pos |
| Vimentin, Carbonic Anhydrase IX generally pos |
Vimentin, Carbonic Anhydrase IX negative |
| Hale colloidal iron negative |
Hale colloidal iron positive |
| Conventional Clear Cell Renal Cell Carcinoma, Granular Variant |
Renal Oncocytoma |
| Nearly always has clear cell areas |
Clear cells only in focal, hyalinized scar areas |
| Prominent surrounding capillary network |
Surrounding stroma hypocellular |
| Carbonic anhydrase IX, AMACR/racemase, vimentin usually pos |
Carbonic anhydrase IX, AMACR/racemase, vimentin usually neg |
| cKIT/CD117 usually neg |
cKIT/CD117 usually pos |
| Conventional Clear Cell Renal Cell Carcinoma |
Clear Cell Tubulopapillary Renal Cell Carcinoma |
| Sheets and clusters of cells with extensive vascular network |
Nearly all have branched tubules and anastomosing ribbons |
| Solid areas have clusters more than two cells wide |
Solid areas usually formed by compressed tubules, each only two cells wide |
| May have high grade nuclear features, vascular invasion and necrosis |
Low grade nuclear features, no invasion or necrosis |
| Cysts frequently due to degeneration, lined in areas by multiple layers of cells |
Uniformly lined by single layer of cells |
| Clear cytoplasm apical or diffuse, non-localized |
Frequent regular basal clearing, resembling interval endometrium |
| Usually CK7 neg, CD10 pos |
CK7 pos, CD10 neg to focal |
