High-Grade renal cell carcinoma with emperipolesis: Clinicopathological, immunohistochemical and Molecular-Genetic analysis of 14 cases

Pavla Rotterova, Petr Martinek, Reza Alaghehbandan, Kristyna Prochazkova, Ivan Damjanov, Joanna Rogala, Saul Suster, Delia Perez-Montiel, Isabel Alvarado-Cabrero, Maris Sperga, Marian Svajdler, Kvetoslava Michalova, Kristyna Pivovarcikova, Ondrej Daum, Milan Hora, Martin Dusek, Ondrej Ondic, Adela Stehlikova, Michal Michal, Ondrej Hes (Coresponding Author)

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Emperipolesis has recently been described as a constant feature of “biphasic squamoid” papillary renal cell carcinoma (BPRCC). We also noticed this in some high-grade (HG) RCC, which promoted the present study to estimate the incidence of emperipolesis in RCCs and to describe them in further detail. 14 cases of HGRCC showing emperipolesis were retrieved from our registry. Microscopic examination of filed slides was supplemented with immunohistochemical and molecular-genetic analyses using paraffin embedded tissue. 12 of 14 patients were males with a mean age of 58.6 years (range 41-72 years). Tumor size ranged from 6-16.5 cm (mean of 8.8 cm). Follow up data were available for 8/14 patients (range 0.5-10 years). Metastases were documented in 6 cases. All tumors showed solid-alveolar growth patterns with focal pseudopapillary features, and were composed of large cells with bizarre nuclei and eosinophilic rhabdoid-like cytoplasm. Emperipolesis was a constant and prominent feature in large bizarre cells. All cases were positive for OSCAR, CANH 9, vimentin, cyclin D1, INI-1, and myoD1, while negative for melanocytic markers, CK 7, myoglobin, cathepsin K, and TFE3. VHL gene abnormalities were found in 6/9 analyzable cases, of which 2 demonstrated polysomy of chromosomes 7, 17. Emperipolesis is a rare histomorphologic feature which can be seen not only in BPRCCs but also in highgrade CCRCCs. All RCC cases with prominent emperipolesis fulfilled both morphologic and immunohistochemical diagnostic criteria of high-grade CCRCC. The majority of patients with available follow up information developed metastases.

Original languageEnglish
Pages (from-to)277-287
Number of pages11
JournalHistology and Histopathology
Issue number3
Publication statusPublished - Mar 2018


  • Clear cell renal cell carcinoma
  • Emperipolesis
  • High-grade
  • Kidney

Field of Science*

  • 3.1 Basic medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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