Surgical Pathology Criteria

Xp11 / TFE3 Translocation Carcinoma of the Kidney

Differential Diagnosis

Immunohistochemistry for the differential diagnosis of renal MiT translocation carcinomas

  CD10 Racemase CK7 EMA CD117
MiT Translocation Ca >90% >90% neg neg neg
Clear Cell Ca >90% 0-20% neg >90% neg
Papillary Ca >90% >90% >90% >90% neg
Chromophobe Ca neg neg >90% >90% >90%
Nuclear staining for TFE3 and/or TFEB (if available) appears to be sensitive and specific for translocation carcinoma

MiT Family Translocation Renal Cell Carcinoma Clear Cell Papillary Renal Cell Carcinoma
Frequently occurs under age 20 Mean age 60
Typically high grade nuclear features Low grade nuclear features, nuclei linear, apical
Voluminous cytoplasm Moderate amount of clear cytoplasm
TFEB or TPF3 immunostain or FISH positive Lacks TFEB or TPF3 translocations
CK7 and other keratins negative to weak, CD10 pos, Racemase/AMACR pos CK7 strong pos, CD10 neg, Racemase/AMACR neg
Variable expression of melanocytic markers Melanocytic markers neg
CA9 negative CA9 basolateral positive

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