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Collecting Duct Carcinoma
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- Represents 1% of renal tumors
- Gross: often arises in the medullary region of the kidney with extension into the cortex or hilar tissues; demonstrates infiltrative borders with white or gray cut surfaces; central necrosis is common.
- Histologic features:
- appears to be a "blend" of adenocarcinoma and transitional cell carcinoma
- typically arises adjacent to the collecting ducts,where it may initially be confused with an invasive TCC. However, more infiltrative areas of the tumor often demonstrate formation of duct-like or tubular structures, admixed with solid nests or cords of neoplastic cells in a loose basophilic stroma.
- nuclei are highly pleomorphic with thick nuclear membranes and prominent nucleoli
- "hobnail" appearance of the cells lining the duct lumens is classic feature (when you can find it)
- Differential diagnosis:
- TCC: do a vimentin stain, which is positive in CDC and negative in TCC.
- RCC: do Ulex europaeus, which is positive in CDC and negative in RCC.
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