Kidney tumor - adult malignancies
Adult renal cell carcinoma
Clear cell papillary renal cell carcinoma

Author: Nicole K. Andeen, M.D. (see Authors page)

Editor: Maria Tretiakova, M.D.

Revised: 18 November 2016, last major update June 2015

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed search: Clear cell papillary renal cell carcinoma [title]

Cite this page: Clear cell papillary renal cell carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/kidneytumormalignantclearcellpapillary.html. Accessed December 7th, 2016.
Definition / General
  • "Composed of clear cells of low nuclear grade, variable papillary, tubular / acinar and cystic architecture and a characteristic linear arrangement of nuclei away from the basal aspect of cells" (Am J Surg Pathol 2013;37:1469)
  • Considered a distinct entity by ISUP classification of renal neoplasia with characteristic morphology and typical immunohistochemical profile: coexpression of CK7 / CAIX and negative CD10 / AMACR expression (Am J Surg Pathol 2013;37:1469)
Terminology
  • Clear cell papillary RCC and clear cell tubulopapillary RCC are synonymous terms
Epidemiology
Clinical Features
Case Reports
Treatment
  • Resection
Gross Description
Gross Images
Images hosted on PathOut server:

Contributed by Nicole K. Andeen, M.D.:

Clear cell papillary RCC

Micro Description
  • Variable mixture of cystic, branched tubular, solid and papillary components; papillae often tightly packed into anastomosing clear cell ribbons or project into cystic spaces (Am J Surg Pathol 2010;34:1608, Am J Surg Pathol 2013;37:1469, Mod Pathol 2013;26:697)
  • Clear cytoplasm; nuclei aligned away from the basement membrane (resembling secretory pattern endometrium with inverted polarity)
  • Low nuclear grade (Fuhrman grade 1 - 2)
  • Fibrous capsule and variable amounts of hyalinized or sclerotic stroma that may separate tumor into nodules (Am J Surg Pathol 2013;37:1469, Mod Pathol 2011;24:1207)
  • No foamy macrophages, no vascular invasion, no oxalate crystals, no necrosis
Micro Images
Images hosted on PathOut server:

Contributed by Nicole K. Andeen, M.D.:

10x

20x


CK7 positive

CAIX positive

CAIX "cup shaped"
positivity, with absence
of staining along
luminal aspect



Case of the Week 229:





Images hosted on other servers:

Clear cell tumors with papillary architecture

Cytology Description
Cytology Images
Images hosted on other servers:

Minimal nuclear atypia and pleomorphism

Positive Stains
Electron Microscopy Description
Molecular / Cytogenetics Description
Differential Diagnosis