Renal cell carcinoma (RCC)

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Stains & molecular markers
Renal cell carcinoma (RCC)

Author: Chen Yang, M.D.

Editorial Board Member: Christian M. Schürch, M.D., Ph.D.

Deputy Editor-in-Chief: Maria Tretiakova, M.D., Ph.D.

Last author update: 16 February 2022

Last staff update: 16 February 2022

Copyright: 2003-2024, PathologyOutlines.com, Inc.

PubMed Search: RCC marker[TIAB] OR RCC Ma[TIAB]

Table of Contents

Cite this page: Yang C. Renal cell carcinoma (RCC). PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stainsrcc.html. Accessed December 25th, 2024.

Definition / general

Anti renal cell carcinoma (RCC) antibodies detect a 200 kD glycoprotein (gp200), which is a surface membrane molecule located on the brush border of proximal renal tubules (Am J Surg Pathol 2001;25:1485)
Also expressed on the luminal surface of Bowman capsule, parathyroid parenchymal cells and colloid of thyroid follicles

Essential features

Could be helpful in classification of primary and metastatic renal cell carcinomas (Appl Immunohistochem Mol Morphol 2007;15:310, J Cutan Pathol 2007;34:381)
Positive in clear cell, papillary and chromophobe renal cell carcinomas (Am J Surg Pathol 2001;25:1485)
Negative in other renal primary tumors

Terminology

Also called RCC Ma (renal cell carcinoma marker)

Pathophysiology

RCC was originally identified as a marker of proximal convoluted tubule brush borders and luminal surface of Bowman capsule in 1989 (Cancer Res 1989;49:1802)
This scaffolding extracellular matrix protein also known as podocalyxin and represents a human embryonal carcinoma antigen (Biochem Biophys Res Commun 2003;300:285)

Interpretation

Membranous stain

Uses by pathologists

Used for identification of clear cell, papillary and chromophobe renal cell carcinoma
However, due to the lack of sensitivity and specificity and emerging utility for PAX8, CAIX, CK7 and CD117 (c-kit), RCC has become less commonly used by pathologists (Histopathology 2020;77:659 Hum Pathol 2021 May 4 [Epub ahead of print])

Microscopic (histologic) images

Contributed by Chen Yang, M.D.

Tumor cells

Positive staining - normal

Brush border of proximal renal tubules
Luminal surface of Bowman capsule
Parathyroid parenchymal cells and colloid of thyroid follicles

Positive staining - disease

Renal cell carcinoma, clear cell (77 - 84%), papillary (96%) and chromophobe (~10%) type (Am J Surg Pathol 2001;25:1485, Appl Immunohistochem Mol Morphol 2014;22:635, Diagn Cytopathol 2005;33:3)
Expressed in 10 of 16 (63%) metastatic cutaneous renal cell carcinomas (J Cutan Pathol 2007;34:381)

Negative staining

Oncocytoma (0/15)
Transitional cell carcinoma (0/20)
Mesoblastic nephroma (0/3)
Cystic nephroma (0/3)
Lymphoma (0/8)
Angiomyolipoma (0/3)
Mixed stromal and epithelial tumor (0/4)
Nephroblastoma (0/8)
Collecting duct (0%)
Reference: Am J Surg Pathol 2001;25:1485

Sample pathology report

Lymph node, retroperitoneal, biopsy:
- Metastatic carcinoma, suggestive of renal origin (see comment)
- Comment: Sections of the retroperitoneal biopsy show the presence of metastatic tumor cells with abundant clear cytoplasm. A panel of immunohistochemistry stains show tumor cells to be positive for CD10 and RCC Ma, while being negative for CK7, CK20, PAX8, CD117 and CAIX. While the immunohistochemistry profile is not entirely concordant with a renal primary, especially with negative PAX8 and CAIX, the positivity of both CD10 and RCC Ma would suggest possibility of renal primary in the context of known history of renal cell carcinoma. Clinical and radiological correlation is recommended.

Board review style question #1

Which of the following renal neoplasms is most likely negative for RCC?

Chromophobe renal cell carcinoma
Clear cell renal cell carcinoma
Collecting duct carcinoma
Papillary renal cell carcinoma

Board review style answer #1

C. Collecting duct carcinoma

Comment Here

Reference: Renal cell carcinoma (RCC)

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