Sclerosing TFEB Rearrangement Renal Cell Carcinoma: A Recurring Histologic Pattern

Renal cell carcinoma with TFEB rearrangement [t(6;11)(p21;q13)] was initially recognized to be composed of dual populations of large cells with clear cytoplasm and small cells forming rosettes around hyaline material. With increasing awareness, however, the spectrum of described morphology has been found to be more heterogeneous. We report a 54 year-old woman who underwent partial nephrectomy for a 2.4 cm renal mass, composed of fibrosis, hyalinization, calcification and ossification, and a smaller component of epithelioid cells. Immunohistochemical staining revealed diffuse positivity for cytokeratin AE1/AE3 and PAX8, patchy labeling for melan-A, HMB45, and cathepsin K, and negative caldesmon, SMA, TFE3 protein, carbonic anhydrase IX, CD10, CK7, EMA and inhibin. Fluorescence in situ hybridization confirmed rearrangement of TFEB and not TFE3. Together with one recent case in another report, our findings suggest that extensive sclerosis and ossification may be a less common recurring histology of TFEB rearrangement renal cell carcinoma.

Human pathology. 2016 Nov 15 [Epub ahead of print]

Sean R Williamson, John N Eble, Nallasivam Palanisamy

Department of Pathology and Laboratory Medicine, Detroit, MI, USA; Josephine Ford Cancer Institute, Henry Ford Health System, Detroit, MI, USA; Wayne State University School of Medicine, Detroit, MI, USA. Electronic address: ., Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA., Department of Urology, Vattikutti Urology Institute, Henry Ford Health System, Detroit, MI, USA; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA.