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Onkozytäre Tumoren der Niere – neue Differenzialdiagnosen

Oncocytic tumours of the kidney—new differential diagnoses

Zusammenfassung

Hintergrund

Das Spektrum der onkozytären Tumoren der Niere hat sich durch neue Erkenntnisse erweitert.

Fragestellung

Erstellung einer Übersicht zur Differenzialdiagnose onkozytärer Tumoren der Niere.

Material und Methoden

Eine Literaturrecherche zu onkozytären Tumoren der Niere wurde durchgeführt und die etablierten Entitäten werden dargestellt. Mögliche Differenzialdiagnosen werden diskutiert.

Ergebnisse

Neben den bereits anerkannten Entitäten der World Health Organisation (WHO) 2016 gibt es neue Erkenntnisse in der Gruppe der bisher nicht eindeutig klassifizierbaren onkozytären Nierentumoren, bei denen sich Charakteristika in Immunhistochemie und auf molekularer Ebene abzeichnen, die zukünftig eine Etablierung neuer Entitäten anbahnen. Wichtige Differenzialdiagnosen können zudem abgegrenzt werden, was eine spezifische Therapie onkozytärer Nierentumoren ermöglicht.

Schlussfolgerung

Die korrekte Diagnose onkozytärer Nierentumoren ermöglicht nicht nur eine verbesserte Prognoseeinschätzung (und ggf. spezifische Therapieoptionen), sondern ist auch im Hinblick auf eine mögliche Assoziation zu einem Tumordispositionssyndrom klinisch von Bedeutung.

Abstract

Background

Recent developments in differential diagnosis have led to new knowledge about oncocytic renal neoplasms.

Objectives

Overview of differential diagnosis of oncocytic tumours.

Materials and methods

We performed a literature search on oncocytic renal tumours and mapped known tumour types. Possible differential diagnoses are discussed.

Results

Besides the tumour types already acknowledged by the 2016 WHO classification, there is new evidence regarding the group of hard-to-classify oncocytic neoplasms. Findings point to immunohistochemical and molecular characteristics that may lead to the establishment of new entities in the future. In addition, important differential diagnosis can now be identified, facilitating specific therapies for oncocytic renal tumours.

Conclusion

A correct diagnosis of oncocytic renal tumours not only improves prognostic assessment (and, if necessary, specific therapies) but is also clinically relevant regarding a possible association with hereditary tumour syndromes.

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Abbreviations

2SC:

S-(2-Succinyl)-Cystein

CAIX:

Carboanhydrase IX

CK:

Zytokeratin

CYCLOPS:

„Copy number alterations yielding cancer liabilities owing to partial loss“

ESC:

Eosinophil, solide und zystisch

EVT:

„Eosinophilic vacuolated tumour“

FH:

Fumarat-Hydratase

HIF:

Hypoxieinduzierender Faktor

HLRCC:

„Hereditary leiomyomatosis and renal cell carcinoma“

HMB45:

„Human melanoma black 45“

HOT:

„High-grade oncocytic tumour“

ISUP:

International Society of Urological Pathology

LOT:

„Low-grade oncocytic tumour“

MiTF:

Mikrophthalmia-Transkriptionsfaktor-Familie

mTOR:

„Mammalian target of rapamycin“

NOS:

Not otherwise specified

NZK:

Nierenzellkarzinom

PECOME:

perivaskuläre epitheloide Zelltumoren

SDH:

Succinatdehydrogenase

TSC:

„Tuberous sclerosis (complex)“

VHL:

Von Hippel-Lindau

Vim:

Vimentin

WHO:

World Health Organization

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Correspondence to I. Polifka.

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Interessenkonflikt

H. Moch ist „Standing Member“ des Editorial Boards der Blue Book-Serie „WHO Classification of Tumours“. I. Polifka und R. Ohashi geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Polifka, I., Ohashi, R. & Moch, H. Onkozytäre Tumoren der Niere – neue Differenzialdiagnosen. Pathologe (2021). https://doi.org/10.1007/s00292-021-00979-w

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Schlüsselwörter

  • Onkozytom
  • Chromophobes Nierenzellkarzinom
  • ESC
  • SDH
  • MTOR

Keywords

  • Oncocytoma
  • Chromophobe renal cell carcinoma
  • ESC
  • SDH
  • MTOR