RT Journal Article
SR Electronic
T1 Diagnostic approach in TFE3-rearranged renal cell carcinoma: a multi-institutional international survey
JF Journal of Clinical Pathology
JO J Clin Pathol
FD BMJ Publishing Group Ltd and Association of Clinical Pathologists
SP jclinpath-2020-207372
DO 10.1136/jclinpath-2020-207372
A1 Mahmut Akgul
A1 Sean R Williamson
A1 Dilek Ertoy
A1 Pedram Argani
A1 Sounak Gupta
A1 Anna Caliò
A1 Victor Reuter
A1 Satish Tickoo
A1 Hikmat A Al-Ahmadie
A1 George J Netto
A1 Ondrej Hes
A1 Michelle S Hirsch
A1 Brett Delahunt
A1 Rohit Mehra
A1 Stephanie Skala
A1 Adeboye O Osunkoya
A1 Lara Harik
A1 Priya Rao
A1 Ankur R Sangoi
A1 Maya Nourieh
A1 Debra L Zynger
A1 Steven Cristopher Smith
A1 Tipu Nazeer
A1 Berrak Gumuskaya
A1 Ibrahim Kulac
A1 Francesca Khani
A1 Maria S Tretiakova
A1 Funda Vakar-Lopez
A1 Guliz Barkan
A1 Vincent Molinié
A1 Virginie Verkarre
A1 Qiu Rao
A1 Lorand Kis
A1 Angel Panizo
A1 Ted Farzaneh
A1 Martin J Magers
A1 Joseph Sanfrancesco
A1 Carmen Perrino
A1 Dibson Gondim
A1 Ronald Araneta
A1 Jeffrey S So
A1 Jae Y Ro
A1 Matthew Wasco
A1 Omar Hameed
A1 Antonio Lopez-Beltran
A1 Hemamali Samaratunga
A1 Sara E Wobker
A1 Jonathan Melamed
A1 Liang Cheng
A1 Muhammad T Idrees
YR 2021
UL http://jcp.bmj.com/content/early/2021/01/28/jclinpath-2020-207372.abstract
AB Transcription factor E3-rearranged renal cell carcinoma (TFE3-RCC) has heterogenous morphologic and immunohistochemical (IHC) features.131 pathologists with genitourinary expertise were invited in an online survey containing 23 questions assessing their experience on TFE3-RCC diagnostic work-up.Fifty (38%) participants completed the survey. 46 of 50 participants reported multiple patterns, most commonly papillary pattern (almost always 9/46, 19.5%; frequently 29/46, 63%). Large epithelioid cells with abundant cytoplasm were the most encountered cytologic feature, with either clear (almost always 10/50, 20%; frequently 34/50, 68%) or eosinophilic (almost always 4/49, 8%; frequently 28/49, 57%) cytology. Strong (3+) or diffuse (>75% of tumour cells) nuclear TFE3 IHC expression was considered diagnostic by 13/46 (28%) and 12/47 (26%) participants, respectively. Main TFE3 IHC issues were the low specificity (16/42, 38%), unreliable staining performance (15/42, 36%) and background staining (12/42, 29%). Most preferred IHC assays other than TFE3, cathepsin K and pancytokeratin were melan A (44/50, 88%), HMB45 (43/50, 86%), carbonic anhydrase IX (41/50, 82%) and CK7 (32/50, 64%). Cut-off for positive TFE3 fluorescent in situ hybridisation (FISH) was preferably 10% (9/50, 18%), although significant variation in cut-off values was present. 23/48 (48%) participants required TFE3 FISH testing to confirm TFE3-RCC regardless of the histomorphologic and IHC assessment. 28/50 (56%) participants would request additional molecular studies other than FISH assay in selected cases, whereas 3/50 participants use additional molecular cases in all cases when TFE3-RCC is in the differential.Optimal diagnostic approach on TFE3-RCC is impacted by IHC and/or FISH assay preferences as well as their conflicting interpretation methods.