mart-1-antigen and Adenoma--Oxyphilic

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 immunohistochemistry 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, CLTCTFE3, 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 immunohistochemistry should be more than 2+ with a wide range. The translocation-type renal carcinoma seems to be quite rare.

Topics: Adenoma, Oxyphilic; Adult; Aged; Basic Helix-Loop-Helix Leucine Zipper Transcription Factors; Cadherins; Carcinoma, Renal Cell; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Kidney Neoplasms; Male; MART-1 Antigen; Melanosomes; Middle Aged; Mutation; Proto-Oncogene Proteins c-kit; S100 Proteins; Transcription, Genetic; Von Hippel-Lindau Tumor Suppressor Protein

Topics: Adenoma, Oxyphilic; Adrenal Cortex Neoplasms; Antigens, Neoplasm; Female; Humans; Hydrocortisone; Immunohistochemistry; Keratins; MART-1 Antigen; Middle Aged; Neoplasm Proteins; Synaptophysin; Testosterone; Vimentin

Distinguishing adrenal cortical neoplasms from either hepatocellular carcinomas or renal tumors can be difficult. Two recently described antibodies, A103 and inhibin A, are most often reported to be reactive with adrenal cortical neoplasms but with neither hepatocellular carcinoma nor renal cell carcinoma. To compare the sensitivity and specificity of these two antibodies in the diagnosis of adrenal cortical tumors, we stained 22 adrenal cortical adenomas, 4 adrenal cortical carcinomas, 25 hepatocellular carcinomas, and 43 renal tumors, including 33 renal cell carcinomas and 8 oncocytomas, with the A103 and inhibin A using an avidin-biotin complex technique. Fifteen (68%) of 22 adrenal adenomas and 2 (50%) of 4 adrenal cortical carcinomas were reactive with A103. Nineteen (86%) of 22 adrenal adenomas and 3 (75%) of 4 adrenal cortical carcinomas were reactive for inhibin A. None of the renal tumors or hepatocellular carcinomas reacted with A103, but 1 (4%) of 25 hepatocellular carcinomas (a high-grade pleomorphic tumor) and 1 (2%) of 43 renal tumors (a clear-cell renal cell carcinoma) were reactive with inhibin A. The cytoplasmic reactivity for A103 in adrenal tumors was coarsely granular and most common in clear-cell areas. Reactivity for inhibin was either cytoplasmic or membranous and stained both clear-cell and granular areas. We conclude that both antibodies are useful in the immunohistochemical diagnosis of adrenal cortical neoplasms and that A103 is slightly more specific and inhibin slightly more sensitive.

Topics: Adenoma; Adenoma, Oxyphilic; Adrenal Cortex Neoplasms; Antibodies, Monoclonal; Antigens, Neoplasm; Carcinoma, Hepatocellular; Carcinoma, Renal Cell; Diagnosis, Differential; Female; Humans; Immunoenzyme Techniques; Inhibins; Kidney Neoplasms; Liver Neoplasms; Male; MART-1 Antigen; Neoplasm Proteins; Sensitivity and Specificity