The utility of using immunohistochemistry in the differentiation of metastatic, cutaneous clear cell renal cell carcinoma and clear cell hidradenoma. (16th May 2017)

• Record Type: Journal Article
• Authors: Velez, Moises J.; Thomas, Courtney L.; Stratton, Jason; Bergfeld, Wilma; Weaver, Joshua
• Is Part Of: Journal of cutaneous pathology. Volume 44:Number 7(2017)
• Page Start: 612
• Page End: 615
• Publication Date: 2017-05-16
• Subjects: hidradenoma -- clear cell hidradenoma -- renal cell carcinoma -- clear cell renal cell carcinoma -- napsin A -- PAX‐8; Skin -- Diseases -- Periodicals; Dermatology -- Periodicals; 616
• DOI: 10.1111/cup.12946
• Languages: English
• ISSNs: 0303-6987

Abstract

Abstract : Background: Clear cell hidradenoma and cutaneous clear cell renal cell carcinoma (CCRCC) overlap morphologically. The distinction may be difficult in a patient with a history of CCRCC, presenting with a cutaneous nodule, potentially leading to an erroneous diagnosis. We investigated the usefulness of napsin A and paired box gene 8 (PAX‐8) with previously studied markers epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), vimentin and cluster of differentiation marker 10 (CD10) in differentiating CCRCC from hidradenoma. Methods: We evaluated hidradenomas and cutaneous CCRCCs for immunohistochemical expression of napsin A, PAX‐8, EMA, CEA, vimentin and CD10. Results: PAX‐8 was expressed in all CCRCCs (8/8) while negative in hidradenomas. Napsin A was negative in both hidradenomas (0/12) and CCRCCs (0/10). EMA showed membranous reactivity in 11 of 12 hidradenomas and 8 of 10 CCRCCs; and highlighted ductal epithelium in 1 of 12 hidradenomas and cystic areas in 4 of 10 CCRCCs. CD10 showed ductal expression in 3 of 12 hidradenomas and membranous staining in 8 of 9 CCRCCs. CEA highlighted ductal epithelium in 11 of 12 hidradenomas while absent in CCRCCs (0/10). Vimentin highlighted neoplastic cells in 8 of 8 CCRCCs and failed to stain the hidradenomas (0/12). Conclusion: A conservative immunohistochemical panel including PAX‐8, vimentin and CEA allow for easy distinction of CCRCC from hidradenoma, whereas napsin A added no additional value.