Kidney tumor
Adult renal cell carcinoma
Papillary renal cell carcinoma (PRCC)

Author: Nicole K. Andeen, M.D.
Editor: Maria Tretiakova, M.D., Ph.D.
Deputy Editor Review: Debra Zynger, M.D.

Revised: 24 April 2018, last major update March 2018

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: "Papillary type" renal cell carcinoma kidney

See Also: Type 1, Type 2, Solid pattern
Cite this page: Andeen, N.K. Papillary renal cell carcinoma (PRCC). PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/kidneytumormalignantrccpap.html. Accessed November 14th, 2018.
Definition / general
Essential features
  • Papillary renal cell carcinoma (PRCC) comprises more than one entity which may have morphologic overlap but have distinct molecular pathways and clinical behavior, currently grouped at least into type 1 and type 2 PRCC
  • Subclassification (type 1 or 2) and exclusion of other renal cell carcinomas with papillary architecture is important
    • Type 1 PRCC:
      • Papillae are lined by a single layer of cells with scanty basophilic cytoplasm and low nuclear grade
      • Have +7, +17 and other trisomies, MET mutations, better prognosis
    • Type 2 PRCC:
      • Papillae are lined by pseudostratified layers of cells with more abundant eosinophilic cytoplasm and higher nucleolar grade
      • Multiple genetic changes described, likely represents more than one entity, worse prognosis
Epidemiology
Sites
  • Kidney
Pathophysiology
  • Depends on subtype
Etiology
Clinical features
Diagnosis
  • In one series of papillary renal cell carcinomas, roughly 25% had classical type 1 features, 25% were type 2 and 50% had some degree of overlapping features (Am J Surg Pathol 2014;38:887)
Radiology description
Radiology images

Images hosted on other servers:

CT scan upper pole tumor

Prognostic factors
  • Need to distinguish between type 1 and type 2 papillary renal cell carcinoma for accurate prognosis
Case reports
Treatment
Gross description
Gross images

Images hosted on PathOut server:

Contributed by Nicole K. Andeen, M.D.
and Maria Tretiakova, M.D., Ph.D.

PRCC



Images hosted on other servers:

Tan pink mass with satellite nodules

Renal vein extension

Large cystic tumor infiltrates perirenal fat

Hemorrhagic and partially necrotic tumor

Multiple tumor nodules, one is hemorrhagic cystic

Capsular invasion

Microscopic (histologic) description
Microscopic (histologic) images

Images hosted on PathOut server:

Contributed by Nicole K. Andeen, M.D. and Maria Tretiakova, M.D., Ph.D.

Type 1

Type 2

Mixed type 1 and type 2


Type 1 PRCC

Type 2 PRCC with focal CK7 expression and diffuse AMACR expression (red)



Contributed by Semir Vranić, M.D., Ph.D., University of Sarajevo (Bosnia):

Oncocytic "variant" of papillary renal cell carcinoma

Cytology description
Cytology images

Images hosted on other servers:

Various Images

Negative stains
Electron microscopy description
  • Variably sized microvilli, small amounts of cytoplasmic lipid, no glycogen
Molecular / cytogenetics description
Differential diagnosis
Board review question #1
Given the sometimes broad differential, what is generally the most useful group of stains for evaluating a renal cell carcinoma with papillary architecture?

  1. CAIX, CK7, AMACR, TFE3
  2. p53, p63, CD10
  3. PAX8, RCC, Hale colloidal iron
  4. Vimentin, RCC, CD10
Board review answer #1
A. CAIX, CK7, AMACR, TFE3