Calcium oxalate deposition in renal cell carcinoma associated with acquired cystic kidney disease: A comprehensive study

Norbert Sule, Ulkem Yakupoglu, Steven Shen, Bhuvaneswari Krishnan, Guang Yang, Seth Lerner, David Sheikh-Hamad, Luan Truong

Research output: Contribution to journalArticle

76 Scopus citations

Abstract

The main complication of acquired cystic kidney disease (ACKD) is frequent development of renal tumors, including renal cell carcinoma (RCC). Intratumoral deposition of calcium oxalate (CaOx) is a distinct feature of ACKD-associated RCCs, but several features of this type of RCC are not known. Features of the 30 end-stage renal disease (ESRD)-associated RCCs identified within a 13-year period, including eight with CaOx deposition, were analyzed. Pathologic and clinical features of CaOx positive (+) and negative (-) RCCs were evaluated and compared. The CaOx+ RCCs showed higher tendency for bilaterality and multifocality. Seven tumors displayed distinctive morphologic features characterized by tumor cells with ill-defined cell membrane, abundant granular eosinophilic cytoplasm, large nuclei, and prominent nucleoli. One tumor was of clear cell type. Regardless of histologic type, all tumors displayed a proximal tubular differentiation. No significant difference was noted for tumors' stage, proliferation, and apoptosis rate between the CaOx+ and CaOx- RCCs. CaOx+ RCCs account for a significant portion of all ESRD-associated RCCs. The majority of these RCCs display a distinctive morphologic profile. Proximal tubular cell differentiation in conjunction with ESRD-mediated high serum level may be pathogenetically important for intratumoral CaOx deposition. These RCCs seems to have a relatively good prognosis.

Original languageEnglish (US)
Pages (from-to)443-451
Number of pages9
JournalAmerican Journal of Surgical Pathology
Volume29
Issue number4
DOIs
StatePublished - Apr 1 2005

Keywords

  • Acquired cystic kidney disease
  • Calcium oxalate
  • Cell kinetics
  • End-stage kidney disease
  • Renal cell carcinoma

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

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