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Kidney tumor - adult malignancies

Adult renal cell carcinoma

Small cell carcinoma

Reviewers: Sean Williamson, M.D. (see Reviewers page)
Revised: 30 June 2012, last major update June 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Neuroendocrine morphology resembling small cell carcinoma of other organs (pure or admixed with high-grade urothelial carcinoma of the kidney)
● Rare, < 30 cases reported in kidney

Epidemiology
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● Median age 59-63 years, 57-75% women, may arise from high-grade urothelial carcinoma of the kidney (Hum Pathol 2011;42:1792)

Clinical description
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● Highly aggressive behavior; often has local or distant metastases (Cancer 2003;97:1436), hematuria, abdominal pain at presentation

Case reports
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● 71 year old woman with combined small cell-urothelial carcinoma of renal pelvis (Arch Pathol Lab Med 1993;117:239)
● 76 year old woman with gross hematuria (Arch Pathol Lab Med 2001;125:796)
● With metastases to lymph nodes (Am J Surg Pathol 1984;8:855)

Gross description
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● Median 11 cm, mean 7.1 cm in another study, usually invading perinephric adipose tissue (Hum Pathol 2011;42:1792)

Gross images
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Large invasive tumor

Micro description
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● Diffuse growth of small cells with minimal cytoplasm, indistinct nucleoli, high mitotic activity
● Often extensive tumor necrosis (BJU Int 2007;100:1030), frequent necrosis, some with lymphovascular invasion (Hum Pathol 2011;42:1792), similar morphology to small cell carcinoma of lung

Micro images
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Various images

       
Bladder images

Positive stains
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● Pancytokeratin, chromogranin, synaptophysin, CD56, neurofilament, CK 8/18, CK19 (Hum Pathol 2011;42:1792)

Negative stains
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● CD45/LCA

Differential diagnosis
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● Lymphoma: use immunostains to differentiate
● Metastatic small cell lung cancer: clinical history of primary lung tumor, absence of high-grade urothelial component
● Other small blue cell tumors: children may have neuroblastoma, Ewing’s sarcoma/PNET or embryonal rhabdomyosarcoma)

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

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