Kidney tumor
Renal cell carcinoma - common
Papillary solid growth
Last author update: 1 February 2018
Last staff update: 15 October 2024 (update in progress)
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PubMed Search: Solid papillary renal cell carcinoma (Review[ptyp] AND "loattrfree full text"[sb])
See Also: Papillary type, renal cell carcinoma, Type 1, Type 2
Table of Contents
Definition / general | Essential features | Epidemiology | Sites | Case reports | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Molecular / cytogenetics description | Differential diagnosis | Board review style question #1 | Board review style answer #1Cite this page: Andeen NK, Tretiakova M. Papillary solid growth. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/kidneytumormalignantrccpapsldvar.html. Accessed December 4th, 2024.
Definition / general
- Originally described in 1997, similar to type I papillary renal cell carcinoma (PRCC) but lacks true papillae (Am J Surg Pathol 1997;21:1203)
Essential features
- Similar to type 1 PRCC by morphology, immunohistochemistry and cytogenetics but lacks true papillae
Epidemiology
- M:F = 1.7:1
- Comprises less than 3% of all PRCCs
Sites
- Kidney
Case reports
- 31 year old man with sarcomatoid component (Arch Pathol Lab Med 2010;134:1210)
Treatment
- Resection
- If needed, systemic therapy varies and includes tyrosine kinase inhibitors like sorafenib and erlotinib (J Natl Compr Canc Netw 2017;15:804, NCCN: NCCN guidelines [Accessed: 15 March 2021])
Gross description
- Solid, firm, tan
- Multifocal in 20%
- Mean size: 4.1 cm (Histopathology 2013;62:941)
Microscopic (histologic) description
- Solid sheets of cells, often with distinct micronodules resembling abortive papillae or glomeruloid bodies, surrounded by a pseudocapsule (Histopathology 2013;62:941)
- Resembles type 1 PRCC immunophenotypically and genetically but lacks true papillae containing fibrovascular cores (Am J Surg Pathol 1997;21:1203)
- Cells have scant to abundant clear, basophilic or eosinophilic cytoplasm
- Nuclei may be low or high grade, may have nucleoli or nuclear grooves
- May have compact areas of low grade spindle cells lining thin, angulated tubules resembling mucinous tubular and spindle cell carcinoma but no mucinous stroma (Am J Surg Pathol 2008;32:1353)
- May have foamy macrophages, psammoma bodies (Histopathology 2013;62:941)
Microscopic (histologic) images
Contributed by Nicole K. Andeen, M.D. and Maria Tretiakova, M.D., Ph.D.
Solid PRCC
Positive stains
- AMACR, CD10 (focal), CK7, EMA (Histopathology 2013;62:941)
Molecular / cytogenetics description
- Trisomy 7 and 17, similar to type 1 PRCC
Differential diagnosis
- Metanephric adenoma: expresses CD57 and WT1 and is negative for CK7 and AMACR; solid PRCC has opposite staining profile
- Mucinous tubular and spindle cell carcinoma: spindle cell areas are uniformly low grade, no mucinous stroma, no +7 or +17
- PRCC, type 1 or type 2: both have true papillae, which the solid growth pattern lacks
- Synovial sarcoma: may be biphasic (epithelial and mesenchymal components) or monophasic; positive for TLE1 by immunohistochemistry and SYT gene rearrangement
Board review style question #1
Which of the following statements about papillary renal cell carcinoma, solid growth pattern is true?
- Has a poor clinical outcome
- Is a type 2 PRCC with solid growth pattern
- Is immunohistochemically and cytogenetically distinct from both type 1 and type 2 PRCC
- Shares morphologic, immunohistochemical and cytogenetic features with type 1 PRCC but lacks true papillae
Board review style answer #1
D. Shares morphologic, immunohistochemical and cytogenetic features with type 1 PRCC but lacks true papillae
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Reference: Papillary solid growth
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Reference: Papillary solid growth
