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Thyroid-like Follicular Carcinoma of the Kidney

Definition

  • Carcinoma of the kidney with a predominant follicular pattern

Diagnostic Criteria

  • Rare - under 10 cases reported
    • Only series reported is 6 cases (Amin)
  • Micro- and macrofollicular pattern reminiscent of thyroid carcinoma
    • Most follicles filled with eosinophilic proteinaceous fluid
    • No papillae
  • Lined by cells with eosinophilic or amphophilic cytoplasm
    • May have nuclear pseudoinclusions or grooves
  • Surrounded by prominent pseudocapsule
  • Metastasis from the thyroid must be ruled out
    • Must be negative for TTF1 and thyroglobulin
    • Must have no clinical or imaging evidence of thyroid primary
  • Behavior uncertain
    • One case reported with widespread metastases (Dhillon)
  • One problematic case reported (Sterlacci)
    • Renal tumor was negative for TTF1 and thyroglobulin
    • Subsequent lung metastasis was TTF1 positive, thyroglobulin not reported

John P Higgins MD
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342

Original posting:: January 24, 2011

Supplemental studies

Immunohistology

CK7 1/7 pos
AMACR/racemase/P504S 0/6
CD10 1/7 pos
PAX2 1/7 pos
TTF1

neg

Thyroglobulin neg

Classification / Lists

Renal epithelial neoplasms

Bibliography

  • Srigley JR, Delahunt B. Uncommon and recently described renal carcinomas. Mod Pathol. 2009 Jun;22 Suppl 2:S2-S23.
  • Dhillon J, Tannir NM, Matin SF, Tamboli P, Czerniak BA, Guo CC. Thyroid-like follicular carcinoma of the kidney with metastases to the lungs and retroperitoneal lymph nodes. Hum Pathol. 2010 Oct 22. [Epub ahead of print]
  • Amin MB, Gupta R, Ondrej H, McKenney JK, Michal M, Young AN, Paner GP, Junker K, Epstein JI. Primary thyroid-like follicular carcinoma of the kidney: report of 6 cases of a histologically distinctive adult renal epithelial neoplasm. Am JSurg Pathol. 2009 Mar;33(3):393-400.
  • Jung SJ, Chung JI, Park SH, Ayala AG, Ro JY. Thyroid follicular carcinoma-like tumor of kidney: a case report with morphologic, immunohistochemical, and genetic analysis. Am J Surg Pathol. 2006 Mar;30(3):411-5.
  • W, Verdorfer I, Gabriel M, Mikuz G. Thyroid follicular carcinoma-like renal tumor: a case report with morphologic, immunophenotypic, cytogenetic, and scintigraphic studies. Virchows Arch. 2008 Jan;452(1):91-5.
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