renal oncocytoma; renal oxyphilic adenoma
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Epidemiology
- most common in 7th & 8th decade of life[2]
Pathology
- benign adenomas that arise from collecting tubules[2]
Microscopic pathology
- abundant eosinophilic granular cytoplasm
- usually round uniform nuclei, can be some pleomorphism
- Hale colloidal iron stain: negative
- periodic acid Schiff: negative
Clinical manifestations
- generally incidental finding
Laboratory
- vimentin: negative
- band 3 anion exchange protein: positive
- CK7: negative
- low molecular weight cytokeratin: positive
- cytokeratin AE1/AE3: positive
- carbonic anhydrase: positive
- CD10: -/+
- RCC antibody: negative
Radiology
- CT of kidneys
- imaging alone insufficient for distinguishing renal oncocytoma from renal cell carcinoma
- CT-guided core-needle biopsy often insufficient as well
Differential diagnosis
- renal cell carcinoma, chromophobe type (CK7: +, band 3 anion exchange protein: -)
- renal cell carcinoma, clear cell type (vimentin: +, band 3 anion exchange protein: -, CD10: +, RCC antibody: +
Management
- surgical resection generally required for diagnosis