Acceptance of emerging renal oncocytic neoplasms: a survey of urologic pathologists
Oncocytic renal neoplasms are a major source of diagnostic challenge in genitourinary pathology; however, they are typically nonaggressive in general, raising the question of whether distinguishing different subtypes, including emerging entities, is necessary. Emerging entities recently described in...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
Springer
2024
|
| _version_ | 1817931432561999872 |
|---|---|
| author | Mohanty, SK Lobo, A Jha, S Sangoi, AR Akgul, M Trpkov, K Hes, O Mehra, R Hirsch, MS Moch, H Smith, SC Shah, RB Cheng, L Amin, MB Epstein, JI Parwani, AV Delahunt, B Desai, S Przybycin, CG Manini, C Luthringer, DJ Sirohi, D Jain, D Midha, D Browning, L |
| author_facet | Mohanty, SK Lobo, A Jha, S Sangoi, AR Akgul, M Trpkov, K Hes, O Mehra, R Hirsch, MS Moch, H Smith, SC Shah, RB Cheng, L Amin, MB Epstein, JI Parwani, AV Delahunt, B Desai, S Przybycin, CG Manini, C Luthringer, DJ Sirohi, D Jain, D Midha, D Browning, L |
| author_sort | Mohanty, SK |
| collection | OXFORD |
| description | Oncocytic renal neoplasms are a major source of diagnostic challenge in genitourinary pathology; however, they are typically nonaggressive in general, raising the question of whether distinguishing different subtypes, including emerging entities, is necessary. Emerging entities recently described include eosinophilic solid and cystic renal cell carcinoma (ESC RCC), low-grade oncocytic tumor (LOT), eosinophilic vacuolated tumor (EVT), and papillary renal neoplasm with reverse polarity (PRNRP). A survey was shared among 65 urologic pathologists using SurveyMonkey.com (Survey Monkey, Santa Clara, CA, USA). De-identified and anonymized respondent data were analyzed. Sixty-three participants completed the survey and contributed to the study. Participants were from Asia (n = 21; 35%), North America (n = 31; 52%), Europe (n = 6; 10%), and Australia (n = 2; 3%). Half encounter oncocytic renal neoplasms that are difficult to classify monthly or more frequently. Most (70%) indicated that there is enough evidence to consider ESC RCC as a distinct entity now, whereas there was less certainty for LOT (27%), EVT (29%), and PRNRP (37%). However, when combining the responses for sufficient evidence currently and likely in the future, LOT and EVT yielded > 70% and > 60% for PRNRP. Most (60%) would not render an outright diagnosis of oncocytoma on needle core biopsy. There was a dichotomy in the routine use of immunohistochemistry (IHC) in the evaluation of oncocytoma (yes = 52%; no = 48%). The most utilized IHC markers included keratin 7 and 20, KIT, AMACR, PAX8, CA9, melan A, succinate dehydrogenase (SDH)B, and fumarate hydratase (FH). Genetic techniques used included TSC1/TSC2/MTOR (67%) or TFE3 (74%) genes and pathways; however, the majority reported using these very rarely. Only 40% have encountered low-grade oncocytic renal neoplasms that are deficient for FH. Increasing experience with the spectrum of oncocytic renal neoplasms will likely yield further insights into the most appropriate work-up, classification, and clinical management for these entities. |
| first_indexed | 2024-12-09T03:21:56Z |
| format | Journal article |
| id | oxford-uuid:373bf171-863a-4f5a-9185-0d934e6d0415 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-12-09T03:21:56Z |
| publishDate | 2024 |
| publisher | Springer |
| record_format | dspace |
| spelling | oxford-uuid:373bf171-863a-4f5a-9185-0d934e6d04152024-11-15T20:11:28ZAcceptance of emerging renal oncocytic neoplasms: a survey of urologic pathologistsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:373bf171-863a-4f5a-9185-0d934e6d0415EnglishJisc Publications RouterSpringer2024Mohanty, SKLobo, AJha, SSangoi, ARAkgul, MTrpkov, KHes, OMehra, RHirsch, MSMoch, HSmith, SCShah, RBCheng, LAmin, MBEpstein, JIParwani, AVDelahunt, BDesai, SPrzybycin, CGManini, CLuthringer, DJSirohi, DJain, DMidha, DBrowning, LOncocytic renal neoplasms are a major source of diagnostic challenge in genitourinary pathology; however, they are typically nonaggressive in general, raising the question of whether distinguishing different subtypes, including emerging entities, is necessary. Emerging entities recently described include eosinophilic solid and cystic renal cell carcinoma (ESC RCC), low-grade oncocytic tumor (LOT), eosinophilic vacuolated tumor (EVT), and papillary renal neoplasm with reverse polarity (PRNRP). A survey was shared among 65 urologic pathologists using SurveyMonkey.com (Survey Monkey, Santa Clara, CA, USA). De-identified and anonymized respondent data were analyzed. Sixty-three participants completed the survey and contributed to the study. Participants were from Asia (n = 21; 35%), North America (n = 31; 52%), Europe (n = 6; 10%), and Australia (n = 2; 3%). Half encounter oncocytic renal neoplasms that are difficult to classify monthly or more frequently. Most (70%) indicated that there is enough evidence to consider ESC RCC as a distinct entity now, whereas there was less certainty for LOT (27%), EVT (29%), and PRNRP (37%). However, when combining the responses for sufficient evidence currently and likely in the future, LOT and EVT yielded > 70% and > 60% for PRNRP. Most (60%) would not render an outright diagnosis of oncocytoma on needle core biopsy. There was a dichotomy in the routine use of immunohistochemistry (IHC) in the evaluation of oncocytoma (yes = 52%; no = 48%). The most utilized IHC markers included keratin 7 and 20, KIT, AMACR, PAX8, CA9, melan A, succinate dehydrogenase (SDH)B, and fumarate hydratase (FH). Genetic techniques used included TSC1/TSC2/MTOR (67%) or TFE3 (74%) genes and pathways; however, the majority reported using these very rarely. Only 40% have encountered low-grade oncocytic renal neoplasms that are deficient for FH. Increasing experience with the spectrum of oncocytic renal neoplasms will likely yield further insights into the most appropriate work-up, classification, and clinical management for these entities. |
| spellingShingle | Mohanty, SK Lobo, A Jha, S Sangoi, AR Akgul, M Trpkov, K Hes, O Mehra, R Hirsch, MS Moch, H Smith, SC Shah, RB Cheng, L Amin, MB Epstein, JI Parwani, AV Delahunt, B Desai, S Przybycin, CG Manini, C Luthringer, DJ Sirohi, D Jain, D Midha, D Browning, L Acceptance of emerging renal oncocytic neoplasms: a survey of urologic pathologists |
| title | Acceptance of emerging renal oncocytic neoplasms: a survey of urologic pathologists |
| title_full | Acceptance of emerging renal oncocytic neoplasms: a survey of urologic pathologists |
| title_fullStr | Acceptance of emerging renal oncocytic neoplasms: a survey of urologic pathologists |
| title_full_unstemmed | Acceptance of emerging renal oncocytic neoplasms: a survey of urologic pathologists |
| title_short | Acceptance of emerging renal oncocytic neoplasms: a survey of urologic pathologists |
| title_sort | acceptance of emerging renal oncocytic neoplasms a survey of urologic pathologists |
| work_keys_str_mv | AT mohantysk acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT loboa acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT jhas acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT sangoiar acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT akgulm acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT trpkovk acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT heso acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT mehrar acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT hirschms acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT mochh acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT smithsc acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT shahrb acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT chengl acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT aminmb acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT epsteinji acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT parwaniav acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT delahuntb acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT desais acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT przybycincg acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT maninic acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT luthringerdj acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT sirohid acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT jaind acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT midhad acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists AT browningl acceptanceofemergingrenaloncocyticneoplasmsasurveyofurologicpathologists |