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Int J Clin Exp Pathol 2(6),583-587;2009
Original Article
Dysplastic (“in-situ”) Lesions in multofocal renal oncocytomas (oncocytosis)
Jiaoti Huang, Peng Lee, Yoshiki Mikami and Jonathan Melamed
Departments of Pathology, 1David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, 2New York University
Medical Center, New York, NY and 3Kawasaki Medical Center, Kawasaki, Japan
Received 02 March 2009; Accepted in revision 23 May 2009; Available online 18 June 2009
Abstract: Preneoplastic lesions for renal oncocytosis have not been well defined. We have attempted to identify the putative in-situ or
dysplastic change in nephrectomy specimens with oncocytosis. Cases of multiple oncocytoma previously identified in radical nephrectomy
specimens (n = 5) were reviewed for early lesions of renal oncocytosis by light microscopic analysis and by immunohistochemical studies for
p53, bcl2 and MIB-1. Microscopic analysis showed that the renal cortical regions in all cases contain isolated groups of tubules partially or
completely replaced by oncocytic cells with morphologic features resembling tumor cells in oncocytosis. The oncocytic cells within these
tubules are increased in number and are arranged either as solid groups or as single layers in cystically dilated tubules, and may assume a
hobnail appearance. They can be distinguished from small foci of oncocytosis as they do not form a coalescent group but are separated in
part by intervening normal-appearing tubules. Cytologically, the cells have abundant eosinophilic, granular cytoplasm with a low
nuclear/cytoplasmic ratio and demonstrate distinct cell borders. A very characteristic feature of these cells is the retraction space (“windows”)
between the oncocytic cells. Nuclear features of these cells are not distinctive from normal tubules. Immunostaining with Bcl-2, p53 and MIB-1
antibodies also does not differentiate the putative preneoplastic lesions from normal tubules. Thus, recognition of a putative dysplastic lesion
for oncocytosis is possible by routine microscopic analysis. Identification of this lesion in a biopsy or partial nephrectomy specimen should
raise the possibility of the existence of renal oncocytosis (multifocality), leading to adequate clinical management..(IJCEP903001).
Key Words: oncocytoma, oncocytomatosis, dysplasia, kidney, in situ tumor, precursor.
Full text PDF
Address all correspondence to: Jonathan Melamed, M.D., Department of Pathology, New York University Medical Center, 560 First Avenue,
New York, NY 10016. Tel: 212-263-8927; Fax: 212-263-7916; Email: Jonathan.melamed@nyumc.org
Original Article
Dysplastic (“in-situ”) Lesions in multofocal renal oncocytomas (oncocytosis)
Jiaoti Huang, Peng Lee, Yoshiki Mikami and Jonathan Melamed
Departments of Pathology, 1David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, 2New York University
Medical Center, New York, NY and 3Kawasaki Medical Center, Kawasaki, Japan
Received 02 March 2009; Accepted in revision 23 May 2009; Available online 18 June 2009
Abstract: Preneoplastic lesions for renal oncocytosis have not been well defined. We have attempted to identify the putative in-situ or
dysplastic change in nephrectomy specimens with oncocytosis. Cases of multiple oncocytoma previously identified in radical nephrectomy
specimens (n = 5) were reviewed for early lesions of renal oncocytosis by light microscopic analysis and by immunohistochemical studies for
p53, bcl2 and MIB-1. Microscopic analysis showed that the renal cortical regions in all cases contain isolated groups of tubules partially or
completely replaced by oncocytic cells with morphologic features resembling tumor cells in oncocytosis. The oncocytic cells within these
tubules are increased in number and are arranged either as solid groups or as single layers in cystically dilated tubules, and may assume a
hobnail appearance. They can be distinguished from small foci of oncocytosis as they do not form a coalescent group but are separated in
part by intervening normal-appearing tubules. Cytologically, the cells have abundant eosinophilic, granular cytoplasm with a low
nuclear/cytoplasmic ratio and demonstrate distinct cell borders. A very characteristic feature of these cells is the retraction space (“windows”)
between the oncocytic cells. Nuclear features of these cells are not distinctive from normal tubules. Immunostaining with Bcl-2, p53 and MIB-1
antibodies also does not differentiate the putative preneoplastic lesions from normal tubules. Thus, recognition of a putative dysplastic lesion
for oncocytosis is possible by routine microscopic analysis. Identification of this lesion in a biopsy or partial nephrectomy specimen should
raise the possibility of the existence of renal oncocytosis (multifocality), leading to adequate clinical management..(IJCEP903001).
Key Words: oncocytoma, oncocytomatosis, dysplasia, kidney, in situ tumor, precursor.
Full text PDF
Address all correspondence to: Jonathan Melamed, M.D., Department of Pathology, New York University Medical Center, 560 First Avenue,
New York, NY 10016. Tel: 212-263-8927; Fax: 212-263-7916; Email: Jonathan.melamed@nyumc.org
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