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Carcinoma de Células Renais
Da Anatomia Patológica para a Clínica - 2para a Clínica - 2
Dr. Pedro OliveiraHospital da Luz Lisboa, Portugal
Carcinoma de céls. renais com translocação da família MiT
2
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
família MiT
MiT Family Translocation-Associated Renal Cell Carcinoma
Arch Pathol Lab Med—Vol 139, October 2015
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
A Contemporary Update With Emphasis on Morphologic, Immunophenotypic, and Molecular Mimics
Martin J. Magers, MD; Aaron M. Udager, MD, PhD; Rohit Mehra, MD
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
Xp11 (TFE3)40% dos casos pediátricos de CCR e < 5% dos
do adulto Associação a quimioterapia prévia
Suspeita em H&E: céls. grandes epitelióides de citoplasma claro ou eosinófilo, alto-grau citoplasma claro ou eosinófilo, alto-grau nuclear, de disposição papilar ou em ninhos sólidos com corpos psamomatosos
Diagnóstico: PAX8, TFE3 IHQ/FISH
Melhor prognóstico no grupo pediátrico; nos adultos igual ao CCR células claras
via molecular do MET
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
t(6:11) (TFE3)
Raro - grupo pediátrico e adultos
Associação a quimioterapia prévia
Suspeita em H&E: padrão bifásico com Suspeita em H&E: padrão bifásico com células epitelióides grandes e uma população secundária de céls. pequenas, eosinófilas dispostas em rosetas
Diagnóstico: PAX8, TFEB IHQ/FISH
Curso indolente/Excelente prognóstico
via molecular do MET
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
Carcinoma de céls. renais deficiente em SDH 3
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
(Succinato desidrogenase)
Succinate dehydrogenase-deficient renal cell carcinoma: detailed characterization of 11 tumors defining a unique subtype of renal cell carcinomaSean R Williamson , John N Eble , Mahul B Amin , Nilesh S Gupta , Steven C Smith , Lynette
M o d e r n P a t h o l o g y (2015) 28, 80–94
& 2015 USCAP, Inc All rights reserved 0893-3952/15 $32.00
Carcinoma de células renais:Da Anatomia Patológica para a Clínica
Sean R Williamson1, John N Eble2, Mahul B Amin3, Nilesh S Gupta1, Steven C Smith3, Lynette M Sholl4, Rodolfo Montironi5, Michelle S Hirsch4 and Jason L Hornick4
1Department of Pathology and Laboratory Medicine, Henry Ford Health System, Detroit, MI, USA; 2Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; 3Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA; 4Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA and 5Institute of Pathological Anatomy and Histopathology, School of Medicine, Polytechnic University of the Marche Region (Ancona), United Hospitals, Ancona, Italy
Carcinoma de células renais:Da Anatomia Patológica para a Clínica
Muito Raro
Mutações germinais na SDH causam um risco
em vida de 14% para desenvolvimento CCR
Associação frequente a paragangliomas, GISTs,
adenomas hipófise, feocromocitomas
Carcinoma de células renais:Da Anatomia Patológica para a Clínica
adenomas hipófise, feocromocitomas
Adultos jovens
Suspeita em H&E: sólido, oncocitóide, vacúolos intracitoplasmáticos, núcleos de baixo-grau; raramente alto-grau ou necrose.
Diagnóstico: IHQ: SDHB(-), CD117 (+), PAX-8 (+)
Prognóstico variável (30% metastizam)
Succinate Dehydrogenase (SDH)-deficient Renal Carcinoma: A Morphologically Distinct
EntityA Clinicopathologic Series of 36 Tumors From 27 Patients
Am J Surg Pathol ●Volume 38, Number 12, December 2014
ORIGINAL ARTICLE
Carcinoma de células renais:Da Anatomia Patológica para a Clínica
A Clinicopathologic Series of 36 Tumors From 27 Patients
Anthony J. Gill, MD, FRCPA,*wz Ondrej Hes, MD,y Thomas Papathomas, MD,8
Monika Sˇedivcova´, MSc,y Puay Hoon Tan, MD,z Abbas Agaimy, MD,#
Per Arne Andresen, MSc,** Andrew Kedziora, FRCPA,w Adele Clarkson, BSc,*w Christopher W. Toon,
FRCPA,wzww Loretta Sioson, BSc,wz Nicole Watson,w
Angela Chou, FRCPA,wzz Julie Paik, MBBS,*w Roderick J. Clifton-Bligh, PhD, FRACP,zyy Bruce G.
Robinson, MD, FRCPA,zyy Diana E. Benn, PhD,zyy Kirsten Hills, FRCPA,88 Fiona Maclean,
FRCPA,zz Nicolasine D. Niemeijer, MD,##
Ljiljana Vlatkovic, MD,*** Arndt Hartmann, MD,# Eleonora P.M. Corssmit, MD,## Geert J.L.H. van
Leenders, MD,PhD,8 Christopher Przybycin, MD,www
Jesse K. McKenney, MD,www Cristina Magi-Galluzzi, MD,PhD,www Asli Yilmaz, MD,zzz Darryl
Yu, MD,zzz Katherine D. Nicoll, FRCPA,yyy Jim L. Yong, FRCPA,yyy
Mathilde Sibony, MD, PhD,888 Evgeny Yakirevich, MD, DSc,zzz Stewart Fleming, MD, FRCPATH,###
Chung W. Chow, FRCPA,**** Markku Miettinen, MD,wwww
Michal Michal, MD,y and Kiril Trpkov, MDzzz
Carcinoma céls. renais associados ao ALK (quinase do Linfoma anaplásico)
4
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
do Linfoma anaplásico)
Renal cell carcinoma with novel VCL–ALK fusion: new representative of ALK-associated tumor spectrum
Modern Pa tho logy (2011) 24, 430–442
& 2011 USCAP, Inc. All rights reserved 0893-3952/11 $32.00
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
Larisa V Debelenko1, Susana C Raimondi1, Najat Daw2, Bangalore R Shivakumar1, Dali Huang3, Marilu Nelson4 and Julia A Bridge3,4,5
1Department of Pathology, St Jude Children’s Research Hospital, Memphis, TN, USA; 2Department of Oncology, St Jude
Children’s Research Hospital, Memphis, TN, USA; 3Department of Pathology and Microbiology, University of Nebraska
Medical Center, Omaha, NE, USA; 4Department of Pediatrics/Meyer Munroe Institute, University of Nebraska Medical
Center, Omaha, NE, USA and 5Department
of Orthopedic Surgery, University of Nebraska Medical Center, Omaha, NE, USA
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
ALK alterations in adult renal cell carcinoma: frequency, clinicopathologic features and outcome in a large series of consecutively treated patients
Modern Pa tho logy (2012) 25, 1516–1525& 2012 USCAP, Inc. All rights reserved 0893-3952/12 $32.00
Carcinoma de células renais:Da Anatomia Patológica para a Clínica
treated patients
William R Sukov1, Jennelle C Hodge1, Christine M Lohse2, Monica K Akre1, Bradley C Leibovich3, R Houston Thompson3 and John C Cheville1
1Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, MN, USA; 2Division of Biomedical
Statistics & Informatics, Mayo Clinic, Rochester, MN, USA and 3Department of Urology, Mayo Clinic, Rochester,
MN, USA
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
Muito Raro - crianças/adultos
No grupo pediátrico associado a Anemia Falciforme
Suspeita em H&E: papilar/sólido e
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
Suspeita em H&E: papilar/sólido e oncocitico
Diagnóstico: ALK IHQ/FISH
Mau prognóstico
crizotinib (Xalkori®) e ceritinib (Zykadia®)
Carcinoma céls. renais associados à 5
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
associados à Leiomiomatose hereditária
Short Communication
American Journal of Pathology, Vol. 159, No. 3, September 2001
Copyright © American Society for Investigative Pathology
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
Familial Cutaneous Leiomyomatosis Is a Two-Hit
Condition Associated with Renal Cell Cancer of
Characteristic Histopathology
Inherited susceptibility to uterine leiomyomas and
renal cell cancer
PNAS | March 13, 2001 | vol. 98 | no. 6 | 3387–3392
Carcinoma de células renais:Da Anatomia Patológica para a Clínica
renal cell cancerVirpi Launonen*†, Outi Vierimaa†‡, Maija Kiuru*†, Jorma Isola§, Stina Roth*, Eero Pukkala¶, Pertti Sistonen" , Riitta Herva**, and Lauri A.
Aaltonen*††
*Department of Medical Genetics, Haartman Institute, University of Helsinki, P. O. Box 21, FIN-00014, Helsinki, Finland; ‡Department of Clinical Genetics, Oulu University
Hospital, Kajaanintie 50, FIN-90220, Oulu, Finland; §Institute of Medical Technology, University of Tampere, FIN-33014, Tampere, Finland;¶Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Finnish Cancer Registry, FIN-00170, Helsinki, Finland;"Finnish Red Cross Blood Transfusion Service, Kivihaantie 7, FIN-00310, Helsinki, Finland; and **Department of Pathology, Oulu University Hospital, Kajaanintie 52, FIN-90220,
Oulu, Finland
Autossómico dominante/Fumarato
Mulheres < 30 anos (50% dos casos)
Leiomiomas cutâneos e uterinos
Suspeita em H&E: papilar de alto grau;
Carcinoma de células renais:Da Anatomia Patológica para a Clínica
Suspeita em H&E: papilar de alto grau;
nucléolo proeminente com halo
perinucleolar
Diagnóstico: clínica+H&E+molecular
Mau prognóstico
Carcinoma de células renais:Da Anatomia Patológica para a Clínica
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
REV IEW
NATURE CLINICAL PRACTICE UROLOGY SUDARSHAN ETAL. FEBRUARY 2007 VOL 4 NO 2
Carcinoma de células renais:Da Anatomia Patológica para a Clínica
REV IEW
www.nature.com/clinicalpractice/uro
Mechanisms of Disease: hereditary leiomyomatosis and renal cell cancer—a distinct form of hereditary kidney cancerSunil Sudarshan, Peter A Pinto, Len Neckers and W Marston Linehan*
VEGF
TGFα GLUT1
PDGF
HIFHPH
O2
HPH
O2
HIF OH VHL complex
HIF HIF OH VHL complex
HIF Degradation: nomoxia
VHL: pseudohypoxia
Carcinoma de células renais:Da Anatomia Patológica para a Clínica
PDGF
EPO
HPH
O2
HIF
HPH
HIF OH HLRCC: pseudohypoxia
Fumarate Malate
Carcinoma céls. renais tubulo-cístico
6
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
renais tubulo-cístico
Tubulocystic Carcinoma of the Kidney
Am J Surg Pathol ● Volume 33, Number 3, March 2009
ORIGINAL ARTICLE
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
Tubulocystic Carcinoma of the Kidney
Clinicopathologic Analysis of 31 Cases of a Distinctive Rare Subtype of Renal Cell Carcinoma
Mahul B. Amin, MD,* Gregory T. MacLennan, MD,w Ruta Gupta, MD,* David Grignon, MD,z Francois
Paraf, MD, PhD,y Annick Vieillefond, MD,J Gladell P. Paner, MD,*
Mark Stovsky, MD, MBA, FACS,w Andrew N. Young, MD, PhD,z John R. Srigley, MD,#
and John C. Cheville, MD **
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
Muito Raro; 60 anos
Aspecto esponjoso; bem circunscrito
H&E: cistos e túbulos com epitélio plano a
“hobnail”; baixo-grau nuclear
Carcinoma de células renais:
Da Anatomia Patológica para a Clínica
“hobnail”; baixo-grau nuclear
Diagnóstico: H&E Prognóstico favorável
10% progridem e podem desdiferenciar (relação com HLRCC?)