Surgical Pathology Criteria

Tubulocystic Carcinoma of the Kidney

Differential Diagnosis

Tubulocystic Carcinoma of the Kidney Collecting Duct Carcinoma
Lacks invasion and desmoplastic stroma Prominent invasion and desmoplastic stroma
Prominently dilated, cystic spaces Predominantly tubules
Lacks necrosis and mitotic figures Frequent necrosis and mitotic figures
Infrequent metastases Frequent metastases at presentation

Tubulocystic Carcinoma of the Kidney Multilocular Renal Cell Neoplasm of Low Malignant Potential
Lining cells have abundant eosinophilic cytoplasm Clear cells line cysts
No nests of clear cells Nests of clear cells in stroma
High grade nuclear features Low grade nuclear features

Tubulocystic Carcinoma of the Kidney Mixed Epithelial and Stromal Neoplasm
Overwhelmingly cystic Cysts common but stroma is prominent
Fibrotic stroma Cellular stroma
Large irregular nuclei Bland nuclei

Tubulocystic Carcinoma of the Kidney Renal Oncocytoma with Cystic Features
Overwhelmingly cystic Usually solid nests with focal cystic dilation
Fibrotic stroma Loose hypocellular stroma
Large irregular nuclei Large round nuclei
Consistent prominent nucleoli Nucleoli variably present
Racemase and CD10 positive Racemase and CD10 usually negative

Tubulocystic Carcinoma of the Kidney Cystic Nephroma
7:1 M:F Nearly all female
High grade nuclear features Low grade nuclear features
Lacks ovarian type stroma Ovarian type stroma

Hereditary Leiomyomatosis RCC Papillary Renal Cell Carcinoma

FH Negative, 2SC Overexpressed

FH intact, No 2SC over expression

CK7 negative

CK7 positive

Prominent eosinophilic nucleoli
with a clear perinucleolar halo

May have prominent nucleoli

Foamy macrophages uncommon

Foamy macrophages common

Average age 36

Average age 60

  • Both may show predominantly papillary architecture
  • HLRCC-associated RCC more likely to resemble Type 2 PRCC with larger tumor cells, often with higher nuclear grade and eosinophilic cytoplasm
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