Surgical Pathology Criteria

Renal Medullary Carcinoma

Differential Diagnosis

Urothelial Carcinoma Medullary Carcinoma of the Kidney
Adjacent usual urothelial carcinoma or carcinoma in situ frequently present Lacks urothelial components
Mean age >50 Mean age 20
No association with sickle cell Associated with sickle cell trait
OCT3/4 negative OCT3/4 69% positive

Medullary Carcinoma of the Kidney Collecting Duct Carcinoma
Frequent solid and/or reticular areas Predominantly tubular and papillary
Mean age 20-24 Mean age 50-55
Associated with sickle cell trait/disease No association with sickle cell
INI negative INI positive in 85%
OCT3/4 69% positive OCT3/4 negative
The distinction may be largely clinical as there is considerable morphologic overlap

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