OneGUPathCasePerWeek @GuPATHWeekly
An account dedicated to Turkish #gupath All cases are non-active and archival. Joined October 2025-
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Low Grade Oncocytic Tumor (LOT) in an adult M, tru-cut biopsy: 🔬H&E: The tumor has eosinophilic cytoplasm, low grade nuclei and solid/nested architecture. Similar to Chromophobe RCC, perinuclear halo can be observed. Like oncocytoma edematous stroma and ''boats in a bay'' pattern can present. 🔍IHC: - Positive: Keratin 7, GATA3, GPNMB. - Negative: KIT. - SDHB and FH retained. 🔑Key Points: - The differential diagnosis of LOT includes oncocytoma, eosinophilic chromophobe RCC, SDH-deficient RCC, and low-grade FH-deficient RCC. Oncocytomas are typically negative for keratin 7, although focal scattered positivity may be seen. Eosinophilic chromophobe RCCs express KIT and are negative for GPNMB. LOTs show retained SDHB and FH expression on immunohistochemistry. - Similar to eosinophilic solid and cystic tumor and eosinophilic vacuolated tumor, LOTs harbor mutations involving the mTOR signaling pathway. - Since its initial description by Trpkov et al. in 2019, no metastatic cases have been reported, and LOT is considered to have an indolent clinical course. 📕Recommended reading: - PMID: 30895640 - PMID: 36208048 - PMID: 35273336
SDH Deficient RCC in a middle aged M, partial nephrectomy: 🔪Gross: 7.6 cm red-brown mass with relatively well delineated borders. 🔬H&E: The tumor shows eosinophilic cytoplasm and low-grade nuclear features. A solid, tubular, or nested growth pattern can be observed. Cystic spaces within the tumor may contain eosinophilic material, and non-neoplastic tubular structures can be entrapped at the periphery. 🔍IHC: - Positive: GATA3 - Negative: KRT7 and KIT - SDHB: Lost 🔑Key Points: - When encountering an eosinophilic renal tumor with low-grade nuclear features that is negative for both KRT7 and KIT, SDH-deficient RCC should be considered. - SDH-deficient RCCs are almost always positive for GATA3 and negative for SDHB. Scattered, focal, or weak non-specific SDHB staining does not exclude the diagnosis; the stain should be interpreted with an appropriate internal positive control. - SDH-deficient RCCs are almost always associated with germline SDH mutations; therefore, genetic counseling and testing are recommended. 📕Recommended reading: - PMID: 40100385 - PMID: 25034258 - PMID: 39562336
Clear Cell Sarcoma of the Kidney in a 23-months-old M with prior chemotherapy: Gross: Well-circumscribed, predominantly solid, partially cystic renal mass (~4 cm) with focal hemorrhage. H&E: The tumor is composed of plump ovoid to polygonal cells arranged in broad trabecular and nested patterns, separated by fibrovascular septa. These septa often display a distinct “chicken-wire” appearance, containing thin-walled capillaries or thickened fibrocollagenous strands. IHC: Positive: Cyclin D1, CD99, Vimentin, BCOR, INI1. Negative: CD34, SMA, S-100, WT-1, PanK. Recommended reading: - PMID: 10632483 - PMID: 29851702 - PMID: 30864973
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Juan Jose Sanchez Ram... @pathologybites
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gulcin guler simsek, ... @glinglerimek
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