Re-evaluation of histological type by immunohistochemical and genetic studyof transcription factors (TFE3 and TFEB) of VHL gene mutation-negative clear cell renal cell carcinoma and other special types of renal tumor

摘要

Department of Diagnostic Pathology, Kochi Red Cross Hospital,2-13-51 Shin-honmachi, Kochi 780-8562, Japan;Department of Urology, Kochi Medical School, Kochi University,Kochi, Japan;Department of Urology, Kochi Medical School, Kochi University,Kochi, Japan;Department of Diagnostic Pathology, Kochi Medical School, KochiUniversity, Kochi, Japan;Department of Pathology, Charles University Hospital Plzen, Plzen,Czech Republic;Department of Pathology, Charles University Hospital Plzen, Plzen,Czech Republic;Department of Diagnostic Pathology, Kochi Red Cross Hospital,2-13-51 Shin-honmachi, Kochi 780-8562, Japan;Department of Diagnostic Pathology, Kochi Red Cross Hospital,2-13-51 Shin-honmachi, Kochi 780-8562, Japan;Department of Pathology, Charles University Hospital Plzen, Plzen,Czech Republic;Department of Diagnostic Pathology, Kochi Red Cross Hospital,2-13-51 Shin-honmachi, Kochi 780-8562, Japan;Department of Urology, Kochi Medical School, Kochi University,Kochi, Japan;Department of Pathology, Kochi Medical School, Kochi University,Kochi, Japan;%Translocation-type renal carcinoma has been recently discovered, and it is possible that this tumor may have been previously diagnosed as other types of renal tumor. We have subjected 41 renal tumors, including VHL gene mutation-negative clear cell renal cell carcinoma (RCC), papillary RCC, and chromophobe RCC, to immu-nohistochemistry of transcription factor E3 (TFE3) and TFEB. All tumors were histologically evaluated by additional immunohistochemical study. As a result, 5 tumors showed a positive reaction for TFE3 with a range from 1+ to 2+ in intensity. No tumors were positive for TFEB. In 5 tumors immunohistochemically positive for TFE3, chimeric transcripts including ASPL-TFE3, PRCC-TFE3, CLTC-TFE3, PSF-TFE3, or Nono-TFE3 were not detected. The diagnosis of 6 tumors was changed by reevaluation through retrospective histological and immunohistochemical study. In 4 of 6 tumors, the diagnosis of clear cell RCC was changed to chromophobe RCC. In 1 tumor, oncocytoma was detectable, and RCC with rhabdoid features and sarcomatoid changes was detected in 1 tumor. Finally, the cutoff value of TFE3 immunohistochernistry should be more than 2+ with a wide range. The translocation-type renal carcinoma seems to be quite rare.