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Kidney tumor - adult malignancies

Adult renal cell carcinoma

Lymphoepithelioma-like carcinoma


Reviewers: Sean Williamson, M.D. (see Reviewers page)
Revised: 29 June 2012, last major update June 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Undifferentiated carcinoma with prominent lymphoid stroma
● Rare in kidney
● May be considered a variant of urothelial carcinoma in renal pelvis (Mod Pathol 2006;19:494)

Case reports
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● 70 year old Japanese man (Mod Pathol 1998;11:1252)
● 75 year old woman (Int J Urol 2007;14:851)

Micro description
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● Undifferentiated round or spindle cell carcinoma will ill-defined borders, arranged in syncytial sheets or small clusters of cells, with abundant inflammatory cells including: T cells, plasma cells, eosinophils, macrophages; indistinguishable microscopically from nasopharyngeal undifferentiated carcinoma (or lymphoepithelioma)

Micro images
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Syncytial arrangement of tumor cells surrounded by lymphocytes

Bladder tumors:
       
Sheets and nests of high grade tumor cells in a syncytial pattern with prominent lymphocytes

Positive stains
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● CK7, CK20 less frequent, EMA, p63, p53, keratin 34βE12 (Am J Surg Pathol 2011;35:474)

Negative stains
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● CD45/LCA (stains lymphocytes, not tumor cells), vimentin, EBV, HPV, TTF1, CD30, AMACR, often CK20- (Am J Surg Pathol 2011;35:474)

Differential diagnosis
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● Lymphoma: no keratin+ tumor cells, lymphocytes are clonal; anaplastic large cell lymphoma is CD30+
● Typical urothelial carcinoma with prominent lymphocytic reaction: lacks syncytial growth pattern
● Xanthogranulomatous pyelonephritis - no keratin+ tumor cells

End of Kidney tumor - adult malignancies > Adult renal cell carcinoma > Lymphoepithelioma-like carcinoma


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