本帖最后由 于 2010-02-24 10:51:00 编辑
Thanks for the invitation to participate this discussion.
It is one of the most common problems in diagnosis of renal neoplasm.
It can be very difficult sometimes as they share similar mormophologic, immunohistochemical, and even cytologenetic abnormalities. There may acturally be hybrid oncocytoma-chromophobe renal cell carcinoma (RCC). I can make a few comments based on my experience and practice.
- Colloidal iron is not terribly useful in dealing with difficult case (it may be helpful to some people)
- Immunostain is not very helpful either for difficult case
- H&E careful morphologic evaluation is still the most useful approach
- Cytologic details are the most useful: oncocytoma - round nuclei with smooth nuclear membrane, diffuse oncocytic cytoplasm, no reticulated cytoplasm, lack of perinuclear halo, no prominent cytoplasmic membrane, usually no necrosis, no mitoses, no clear cells, no papillary configuration
- Oncocytoma can have focal cytologic atypia, cystic changes, hemorrhage, and even fat invasion
Thanks for the invitation to participate this discussion.
It is one of the most common problems in diagnosis of renal neoplasm.
It can be very difficult sometimes as they share similar mormophologic, immunohistochemical, and even cytologenetic abnormalities. There may acturally be hybrid oncocytoma-chromophobe renal cell carcinoma (RCC). I can make a few comments based on my experience and practice.
- Colloidal iron is not terribly useful in dealing with difficult case (it may be helpful to some people)
- Immunostain is not very helpful either for difficult case
- H&E careful morphologic evaluation is still the most useful approach
- Cytologic details are the most useful: oncocytoma - round nuclei with smooth nuclear membrane, diffuse oncocytic cytoplasm, no reticulated cytoplasm, lack of perinuclear halo, no prominent cytoplasmic membrane, usually no necrosis, no mitoses, no clear cells, no papillary configuration
- Oncocytoma can have focal cytologic atypia, cystic changes, hemorrhage, and even fat invasion