Kidney tumor - adult malignancies
Adult renal cell carcinoma
Eosinophilic variant of clear cell renal cell carcinoma

Author: Nicole K. Andeen, M.D. (see Authors page)
Editor: Maria Tretiakova, M.D.

Revised: 30 January 2017, last major update May 2015

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: Eosinophilic [title] clear cell renal cell carcinoma

Cite this page: Eosinophilic variant of clear cell renal cell carcinoma. PathologyOutlines.com website. http://pathologyoutlines.com/topic/kidneytumormalignantclearcelleosinophilic.html. Accessed March 28th, 2017.
Definition / General
  • Clear cell renal cell carcinoma (RCC) with prominent areas of eosinophilic cytoplasm
    • May mimic another subtype of RCC, particularly on small biopsies
  • Often associated with areas of higher grade and stage, extensive (> 50%) necrosis and higher risk of progression (Arch Pathol Lab Med 2014;138:1531, Am J Surg Pathol 2000;24:1247)
Terminology
  • Not a distinct subtype of clear cell (conventional) RCC (Am J Surg Pathol 2013;37:1469)
  • Former "granular cell variant" terminology is discouraged, as multiple distinct tumor subtypes may be falsely categorized together
Clinical Features
Radiology Images

Images hosted on other servers:

Contrast CT scan

Prognostic Factors
Case Reports
  • 22 year old woman with renal epithelioid angiomyolipoma presenting clinically as renal cell carcinoma (Af J Urol 2014;20:197)
  • 54 year old woman with renal cell carcinoma metastasis to the ovary (Cases J 2009;2:7472)
Treatment
  • Resection
  • Targeted therapy (tyrosine kinase inhibitors, VEGF inhibitors, mTOR inhibitors), cytokine therapy
Gross Description
Gross Images

Images hosted on other servers:

Kidney RCC eosinophilic

Micro Description
  • Cytoplasmic features:
    • Variable fine to coarse eosinophilic granularity, distributed irregularly
    • Occasional numerous eosinophilic inclusions and hyaline globules
  • Nuclear features: predominantly higher grade areas
  • Classic clear cell areas present elsewhere
Micro Images

Images hosted on other servers:

Neoplastic cells have variable eosinophilic and conventional clear cell features

Figure 3


With eosinophilic hyaline globules

Cytology Description
  • May have bland cytomorphology, difficult to distinguish from other renal oncocytic neoplasms on FNA (Cancer 2001;93:390)
Electron Microscopy Description
  • Similar to classic type (with abundant lipid and glycogen) but with more mitochondria that are swollen and pleomorphic, rarefied matrix and attenuated cristae (Am J Surg Pathol 2000;24:1247)
  • May have scant microvesicles
Molecular / Cytogenetics Description
Differential Diagnosis