Diagnostic Biomarkers in Renal Cell Tumors According to the Latest WHO Classification: A Focus on Selected New Entities
by
, , , ,
Francesca Sanguedolce
1, 
Roberta Mazzucchelli
2,
Ugo Giovanni Falagario
3,4,
Angelo Cormio
5,*,
Magda Zanelli
6,
Andrea Palicelli
6
,
Maurizio Zizzo
7,
Albino Eccher
8,
Matteo Brunelli
9, 
Andrea Benedetto Galosi
5,
Giuseppe Carrieri
3 and
Luigi Cormio
3,10 1
Pathology Unit, Policlinico Foggia, University of Foggia, 71122 Foggia, Italy
2
Section of Pathological Anatomy, Department of Biomedical Sciences and Public Health, United Hospitals, Università Politecnica delle Marche, 60126 Ancona, Italy
3
Department of Urology and Renal Transplantation, Policlinico Foggia, University of Foggia, 71122 Foggia, Italy
4
Department of Molecular Medicine and Surgery, Karolinska Institutet, 17177 Stockholm, Sweden
5
Department of Urology, Azienda Ospedaliero-Universitaria Ospedali Riuniti Di Ancona, Università Politecnica Delle Marche, Via Conca 71, 60126 Ancona, Italy
6
Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
7
Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
8
Department of Pathology and Diagnostics, University and Hospital Trust of Verona, 37126 Verona, Italy
9
Department of Pathology and Diagnostics and Public Health, Section of Pathology, University Hospital of Verona, 37126 Verona, Italy
10
Department of Urology, Bonomo Teaching Hospital, 76123 Andria, Italy
*
Author to whom correspondence should be addressed.
Cancers 2024, 16(10), 1856; https://doi.org/10.3390/cancers16101856
Submission received: 14 April 2024
/
Revised: 2 May 2024
/
Accepted: 9 May 2024
/
Published: 13 May 2024
(This article belongs to the Special Issue New Insights into Urologic Oncology)
Simple Summary
The latest World Health Organization classification for kidney tumors, released in 2022, brings important changes, introducing new types of tumors and refining the names of certain diseases. This classification highlights the need for both traditional and modern methods in diagnosing these tumors, including molecular and genetic analysis alongside conventional microscopic examination. Our article focuses on the role of specific markers identified through immunohistochemistry, a technique used to study proteins in tissues, in diagnosing these new tumors. We critically discuss the features of these tumors, such as the clear cell capillary renal cell tumor, eosinophilic solid and cystic renal cell carcinoma, and other oncocytic tumors. By understanding these markers and their significance, pathologists can better diagnose these tumors, leading to improved treatment strategies and outcomes for patients. Our review provides valuable insights into these novel tumors, offering guidance for healthcare professionals in their daily practice, ultimately benefiting society by enhancing diagnostic accuracy and patient care.
Abstract
The fifth edition of the World Health Organization (WHO) classification for urogenital tumors, released in 2022, introduces some novelties in the chapter on renal epithelial tumors compared to the previous 2016 classification. Significant changes include the recognition of new disease entities and adjustments in the nomenclature for certain pathologies. Notably, each tumor entity now includes minimum essential and desirable criteria for reliable diagnosis. This classification highlights the importance of biological and molecular characterization alongside traditional cytological and architectural features. In this view, immunophenotyping through immunohistochemistry (IHC) plays a crucial role in bridging morphology and genetics. This article aims to present and discuss the role of key immunohistochemical markers that support the diagnosis of new entities recognized in the WHO classification, focusing on critical topics associated with single markers, in the context of specific tumors, such as the clear cell capillary renal cell tumor (CCPRCT), eosinophilic solid and cystic renal cell carcinoma (ESC-RCC), and so-called “other oncocytic tumors”, namely the eosinophilic vacuolated tumor (EVT) and low-grade oncocytic tumor (LOT). Their distinctive characteristics and immunophenotypic profiles, along with insights regarding diagnostic challenges and the differential diagnosis of these tumors, are provided. This state-of-the-art review offers valuable insights in biomarkers associated with novel renal tumors, as well as a tool to implement diagnostic strategies in routine practice.
