Calcium oxalate deposition in renal cell carcinoma associated with acquired cystic kidney disease - A comprehensive study

Sule N., Yakupoglu Ü., Shen S., Krishnan B., Yang G., Lerner S., ...More

AMERICAN JOURNAL OF SURGICAL PATHOLOGY, vol.29, no.4, pp.443-451, 2005 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 29 Issue: 4
  • Publication Date: 2005
  • Doi Number: 10.1097/01.pas.0000152131.58492.97
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.443-451
  • Keywords: acquired cystic kidney disease, renal cell carcinoma, end-stage kidney disease, calcium oxalate, cell kinetics, PRIMARY HYPEROXALURIA, CHRONIC-HEMODIALYSIS, EPITHELIAL-CELLS, LLC-PK1 CELLS, FAILURE, TUMORS, TRANSPLANTATION, PREVALENCE, NEOPLASIA, DIALYSIS
  • Acibadem Mehmet Ali Aydinlar University Affiliated: No


The main complication of acquired cystic kidney disease (ACKD) is frequent development of renal tumors, including renal cell carcinoma (RCC). Intratumoral deposition of calcium oxalate (CaOx) is a distinct feature of ACKD-associated RCCs, but several features of this type of RCC are not known. Features of the 30 end-stage renal disease (ESRD)-associated RCCs identified within a 13-year period, including eight with CaOx deposition, were analyzed. Pathologic and clinical features of CaOx positive (+) and negative (-) RCCs were evaluated and compared. The CaOx+ RCCs showed higher tendency for bilaterality and multifocality. Seven tumors displayed distinctive morphologic features characterized by tumor cells with ill-defined cell membrane, abundant granular eosinophilic cytoplasm, large nuclei, and prominent nucleoli. One tumor was of clear cell type. Regardless of histologic type, all tumors displayed a proximal tubular differentiation. No significant difference was noted for tumors' stage, proliferation, and apoptosis rate between the CaOx+ and CaOx-RCCs. CaOx+ RCCs account for a significant portion of all ESRD-associated RCCs. The majority of these RCCs display a distinctive morphologic profile. Proximal tubular cell differentiation in conjunction with ESRD-mediated high serum level may be pathogenetically important for intratumoral CaOx deposition. These RCCs seems to have a relatively good prognosis.