American Urological Association - Collecting Duct Carcinoma
Collecting Duct Carcinoma
- High-grade adenocarcinoma (gland forming) believed to arise from collecting duct epithelial cells.
- Often centered in medullary region of the kidney with white or gray cut surfaces and central necrosis is common.
- Demonstrates infiltrative borders. (In contrast to most RCC; this feature is also typical for urothelial carcinoma and metastatic tumors to kidney)
- Variable but usually has infiltrative glandular/tubular or papillary architectures (image A) & (image B).
- Presence of desmoplastic stroma. (In contrast to most RCC)
- High-grade cytology with abundant mitosis.
- "Hobnail" appearance of the cells lining (when you can find it).
- Immunohistochemistry: HMWK+.
- Aggressive, frequently presents with higher stage or metastasis.
- ~1/2 of patients dead of disease in 2 years.
- Papillary RCC: also has papillae but with histiocytes and is rarely infiltrative or desmoplastic; AMACR+, CK7+ and HMWK-.
- Urothelial CA: distinction becomes difficult if it has glandular differentiation; look for sheets of typical urothelial carcinoma.
- Metastatic carcinoma