papillary renal cell carcinoma

Papillary renal cell carcinoma (PRCC) is a type of kidney cancer that originates from the renal tubular epithelial cells of the kidney. It accounts for approximately 10-15% of all kidney neoplasms [3]. PRCC can be classified into two main subtypes: type 1 and type 2, also known as eosinophilic [4].

The tumors in PRCC appear as finger-like projections in the renal tubules, which is where they get their name from. Common symptoms of PRCC include blood in the urine, pain, and feeling a mass in your side [5]. The cancer is usually treated with surgery.

PRCC is characterized by cuboidal-shaped cells lining papillary structures, with foamy macrophages within the papillae being a distinctive feature [7]. It is a rare subtype of renal cell carcinoma, arising from the renal tubular epithelium and showing a papillary growth pattern [8].

In some cases, PRCC can be indolent, bilateral, and multifocal, while in others it presents with solitary lesions [9]. Microscopically, PRCC is described as having predominantly papillary or tubulopapillary architecture [10].

Overall, PRCC is a type of kidney cancer that requires prompt medical attention due to its potential severity.

Common Signs and Symptoms of Papillary Renal Cell Carcinoma

Papillary renal cell carcinoma (PRCC) is a type of kidney cancer that can cause various symptoms, which may develop over time. The following are some common signs and symptoms associated with PRCC:

• Blood in the urine: This is one of the most common symptoms of PRCC, where blood appears pink, red, or cola-colored in the urine [2].
• Pain: Back or flank pain can occur as the tumor grows and puts pressure on surrounding tissues [11].
• Weight loss: Unintentional weight loss can be a symptom of PRCC, especially if the cancer has spread to other parts of the body [11].
• Fatigue: Feeling tired or weak is another possible symptom of PRCC [11].
• Intermittent fever: Some people may experience intermittent fever as a symptom of PRCC [11].

It's essential to note that these symptoms can be similar to those experienced by people with other types of kidney cancer. If you're experiencing any of these symptoms, it's crucial to consult a healthcare provider for proper diagnosis and treatment.

Early Detection is Key

In the early stages, PRCC may not show any symptoms at all. However, if detected early, treatment options are more effective, and the chances of recovery improve [7]. Regular check-ups with your healthcare provider can help identify potential issues before they become severe.

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Diagnostic Tests for Papillary Renal Cell Carcinoma

Papillary renal cell carcinoma (PRCC) is a type of kidney cancer that requires accurate diagnosis to determine the best course of treatment. The following diagnostic tests are commonly used to identify PRCC:

• Imaging studies: CT and MRI scans are usually the only tests doctors need to diagnose kidney cancer, including PRCC [6]. These imaging tests can help identify tumors and plan treatment.
• Percutaneous biopsy: In some cases, a percutaneous biopsy may be performed to confirm the diagnosis of PRCC. This involves taking a small sample of tissue from the tumor using a needle [7].
• Contrast-enhanced CT scanning: Contrast-enhanced CT scanning has become the imaging procedure of choice for diagnosis and staging of renal cell cancer, including PRCC [8].
• MRI: MRI is required to diagnose the renal tumor in some cases, especially when papillary carcinomas do not enhance significantly on CT [9].

Additional Diagnostic Tests

In addition to these tests, doctors may also perform:

• Physical exam: A thorough physical exam and medical history are essential to identify any symptoms or risk factors associated with PRCC.
• Laboratory tests: Laboratory tests such as serum creatinine, glomerular filtration rate (GFR), complete cell blood count, erythrocyte sedimentation rate, liver function tests may be ordered to assess the patient's overall health and potential impact of the cancer [5].
• Urinalysis: A test to look for the presence of blood in the urine under a microscope is often the first test that is ordered.

Differential Diagnosis of Papillary Renal Cell Carcinoma

Papillary renal cell carcinoma (pRCC) is a type of kidney cancer that can be challenging to diagnose due to its similarity in appearance to other types of renal tumors. The differential diagnosis for pRCC includes several entities, which are discussed below:

• Clear cell papillary renal cell carcinoma: This subtype of pRCC has been cleared out as a distinct entity, and the classification of pRCC is changing due to the discovery of novel tumor entities [10].
• Distal tubular cells, proximal tubular cells, oncocytoma, and other types of renal cell carcinoma: These entities can be considered in the differential diagnosis for pRCC, particularly when evaluating tumors with papillary growth patterns [3].
• Cystic renal disease: This condition can also be included in the differential diagnosis for pRCC, especially when evaluating tumors with cystic components [3].
• TFE3 translocation-associated renal cell carcinoma: This aggressive entity is another consideration in the differential diagnosis for T2PRCC (type 2 papillary renal cell carcinoma) [5].

Key Points to Consider

When differentiating pRCC from other types of renal tumors, it's essential to consider the following:

• Immunohistochemical profile: The immunohistochemical profile can help distinguish pRCC from other entities, such as clear cell papillary renal cell carcinoma [10].
• Genomic heterogeneity: The genomic heterogeneity in T2PRCC can make differential diagnosis more challenging, and a variety of other renal tumors should be considered in the differential diagnosis for this subtype [15].

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