Kidney tumor

Adult renal cell carcinoma - common

Clear cell papillary

Topic Completed: 1 June 2015

Minor changes: 1 June 2021

Copyright: 2003-2021,, Inc.

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

Nicole K. Andeen, M.D.
Maria Tretiakova, M.D., Ph.D.
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Cite this page: Andeen NK, Tretiakova M. Clear cell papillary. website. Accessed October 25th, 2021.
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)
  • Clear cell papillary RCC and clear cell tubulopapillary RCC are synonymous terms
Clinical features
Case reports
  • Resection
Gross description
Gross images

Contributed by Debra Zynger, M.D.

Transplanted kidney

End stage kidney

Partial nephrectomy

Polycystic kidney

 Contributed by Nicole K. Andeen, M.D.

Clear cell papillary RCC

Microscopic (histologic) 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
Microscopic (histologic) images

Contributed by Nicole K. Andeen, M.D.



CK7 positive

CAIX positive

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

Case of the Week #229

Various images

Various images

Cytology description
Positive stains
Electron microscopy description
Molecular / cytogenetics description
Differential diagnosis
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