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Kidney tumor - adult malignancies

Adult renal cell carcinoma

Primary thyroid-like follicular 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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● Kidney tumor that mimics well-differentiated thyroid follicular neoplasm

Epidemiology
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● No gender preference, age range of 29-83 years

Clinical description
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● Low malignant potential (1 of 6 metastasized to renal lymph nodes, Am J Surg Pathol 2009;33:393)

Case reports
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● 32 year old woman (Am J Surg Pathol 2006;30:411)
● 61 year old man with mixed papillary RCC and thyroid-like follicular carcinoma (Histopath 2010;57:494)

Gross description
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● 2-4 cm, encapsulated

Micro description
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● Follicular architecture with micro- and macrofollicles containing inspissated colloid-like material
● May have focal tightly packed follicles without secretions
● Follicular cells have moderate amphophilic to eosinophilic cytoplasm, round nuclei, occasional prominent nucleoli

Positive stains
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● CK7, CK20, CAM 5.2, vimentin (Virchows Arch 2008;452:91)

Negative stains
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● Thyroglobulin, TTF1, RCC, CD10

Molecular description
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● Gene expression profile is distinct from clear cell or chromophobe renal cell carcinoma

Differential diagnosis
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● Metastatic thyroid carcinoma: very rare to kidney, usually obvious thyroid primary with widely disseminated metastases, thyroglobulin+ or TTF1+
● Metastatic follicular carcinoma arising in struma ovarii in females
Carcinoid tumor: rare, patterns are insular, cords, nests or ribbons but not follicular; neuroendocrine histology, synaptophysin+, chromogranin+

End of Kidney tumor - adult malignancies > Adult renal cell carcinoma > Primary thyroid-like follicular carcinoma


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