Renal oncocytoma pathophysiology: Difference between revisions

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==Overview==
==Overview==
The exact pathogenesis of [disease name] is not fully understood.
The exact [[pathogenesis]] of renal oncocytoma is not completely understood. Although some mechanisms are suggested in the [[pathogenesis]] of this disease that include, lossing of [[chromosome 1]] and [[dysfunction]] of [[mitochondrial]] [[enzymes]] which is caused by alterations in the [[mitochondrial DNA]]. [[DNA]] [[Diploid|diploidy]] is seen in 96% of [[patients]] with renal oncocytomas. The development of renal oncocytoma is the result of multiple [[genetic mutations]] such as deletion of [[chromosome 1]], deletion of the [[sex chromosome]], [[Translocations|translocation]] of [[chromosome]] 11q13, sporadic or no [[chromosomal]] alteration. Renal oncocytoma can be associated with familial renal oncocytoma or Birt-Hogg-Dube [[syndrome]]. On [[gross]] [[pathology]],  tan to brown surface color , well-encapsulated with a thick, well-defined, [[fibrous]] [[capsule]], central scar, and [[homogeneous]] appearance without any [[hemorrhage]] or [[necrosis]] inside it in the [[tumor]] cut are characteristic findings of renal oncocytoma. On [[microscopic]] [[histopathological]] [[analysis]], renal oncocytoma characterized by "oncocytes". They are large, round to polygonal [[neoplastic]] cells accompanied by [[eosinophilic]] granular [[cytoplasm]] and are organized in nested or organoid pattern. Although, renal oncocytoma is [[benign]], [[atypia]], prominent [[nucleoli]], and [[pleomorphism]] may seen in [[microscopic examination]].
 
OR
 
It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
 
OR
 
[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
 
OR
 
Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
 
OR
 
 
[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
 
OR
 
The progression to [disease name] usually involves the [molecular pathway].
 
OR
 
The pathophysiology of [disease/malignancy] depends on the histological subtype.


==Pathophysiology==
==Pathophysiology==
===Pathogenesis===
===Pathogenesis===
*The exact pathogenesis of [disease name] is not completely understood.
*The exact [[pathogenesis]] of renal oncocytoma is not completely understood.
OR
*The mechanisms which are suggested in the [[pathogenesis]] of renal oncocytoma include:<ref name="Thrash-BinghamSalazar1996">{{cite journal|last1=Thrash-Bingham|first1=Catherine A.|last2=Salazar|first2=Hernando|last3=Greenberg|first3=Richard E.|last4=Tartof|first4=Kenneth D.|title=Loss of heterozygosity studies indicate that chromosome arm 1p harbors a tumor suppressor gene for renal oncocytomas|journal=Genes, Chromosomes and Cancer|volume=16|issue=1|year=1996|pages=64–67|issn=10452257|doi=10.1002/(SICI)1098-2264(199605)16:1<64::AID-GCC9>3.0.CO;2-1}}</ref><ref name="Dijkhuizenvan den Berg1997">{{cite journal|last1=Dijkhuizen|first1=T.|last2=van den Berg|first2=E.|last3=Störkel|first3=S.|last4=de Vries|first4=B.|last5=van der Veen|first5=A.Y.|last6=Wilbrink|first6=M.|last7=Geurts van Kessel|first7=A.|last8=de Jong|first8=B.|title=Renal oncocytoma with t(5;12;11), der(1)t(1;8) and add(19): “true” oncocytoma or chromophobe adenoma?|journal=International Journal of Cancer|volume=73|issue=4|year=1997|pages=521–524|issn=00207136|doi=10.1002/(SICI)1097-0215(19971114)73:4<521::AID-IJC11>3.0.CO;2-C}}</ref><ref name="NeuhausDijkhuizen1997">{{cite journal|last1=Neuhaus|first1=Christine|last2=Dijkhuizen|first2=T.|last3=van den Berg|first3=E.|last4=Störkel|first4=S.|last5=Stöckle|first5=M.|last6=Mensch|first6=B.|last7=Huber|first7=C.|last8=Decker|first8=H.-J.|title=Involvement of the chromosomal region 11q13 in renal oncocytoma: Case report and literature review|journal=Cancer Genetics and Cytogenetics|volume=94|issue=2|year=1997|pages=95–98|issn=01654608|doi=10.1016/S0165-4608(96)00205-1}}</ref><ref>{{Cite journal
*It is understood that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
| author = [[C. Welter]], [[G. Kovacs]], [[G. Seitz]] & [[N. Blin]]
*[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
| title = Alteration of mitochondrial DNA in human oncocytomas
*Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
| journal = [[Genes, chromosomes & cancer]]
*[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
| volume = 1
*The progression to [disease name] usually involves the [molecular pathway].
| issue = 1
*The pathophysiology of [disease/malignancy] depends on the histological subtype.
| pages = 79–82
| year = 1989
| month = September
| pmid = 2487148
}}</ref>
**Lossing of [[chromosome 1]]
** [[Dysfunction]] of [[mitochondrial]] [[enzymes]] which is caused by alterations in the [[mitochondrial DNA]]


==Genetics==
==Genetics==
[[DNA]] diploidy is seen in 96% of [[patients]] with renal oncocytomas.<ref>{{Cite journal
[[DNA]] [[Diploid|diploidy]] is seen in 96% of [[patients]] with renal oncocytomas.<ref>{{Cite journal
  | author = [[M. R. Licht]], [[A. C. Novick]], [[R. R. Tubbs]], [[E. A. Klein]], [[H. S. Levin]] & [[S. B. Streem]]
  | author = [[M. R. Licht]], [[A. C. Novick]], [[R. R. Tubbs]], [[E. A. Klein]], [[H. S. Levin]] & [[S. B. Streem]]
  | title = Renal oncocytoma: clinical and biological correlates
  | title = Renal oncocytoma: clinical and biological correlates
Line 114: Line 95:
}}</ref>
}}</ref>


*Familial renal oncocytoma  
*[[Familial]] renal oncocytoma
*Birt-Hogg-Dube [[syndrome]]
*Birt-Hogg-Dube [[syndrome]]


Line 141: Line 122:
  | pmid = 2714326
  | pmid = 2714326
}}</ref>
}}</ref>
[[File:Gross pathology of renal oncocytoma.jpg|350px|none|thumb|https://radiopaedia.org/cases/renal-oncocytoma-gross-pathology-2?lang=us]]
[[File:Gross pathology- coronal section.jpg|350px|none|thumb|https://radiopaedia.org/cases/renal-oncocytoma-pathology-2?lang=us]]
==Microscopic Pathology==
==Microscopic Pathology==
On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
On [[microscopic]] [[histopathological]] [[analysis]], renal oncocytoma characterized by "oncocytes". They are large, round to polygonal [[neoplastic]] cells accompanied by [[eosinophilic]] granular [[cytoplasm]] and are organized in nested or organoid pattern. Although, renal oncocytoma is [[benign]], [[atypia]], prominent [[nucleoli]], and [[pleomorphism]] may seen in [[microscopic examination]].<ref>{{Cite journal
 
| author = [[B. Perez-Ordonez]], [[G. Hamed]], [[S. Campbell]], [[R. A. Erlandson]], [[P. Russo]], [[P. B. Gaudin]] & [[V. E. Reuter]]
Microscopic examination of oncocytomas reveals
| title = Renal oncocytoma: a clinicopathologic study of 70 cases
characteristic features of the cellular architecture,
| journal = [[The American journal of surgical pathology]]
cytoplasm, and nucleus. Uniformity in
| volume = 21
cellular size and color, round to polygonal
| issue = 8
shape, and abundant fine granular cytoplasm are
| pages = 871–883
consistent findings.1,6,13–15,17 Clear cells are not
| year = 1997
present, but foci of cytoplasmic clearing can be
| month = August
seen within the granular cells, distinctive from
| pmid = 9255250
the clear cells seen in RCC.1,2,19 The typical nuclei
}}</ref><ref name="BarnesBeckman1983">{{cite journal|last1=Barnes|first1=C. Allan|last2=Beckman|first2=Edwin N.|title=Renal Oncocytoma and Its Congeners|journal=American Journal of Clinical Pathology|volume=79|issue=3|year=1983|pages=312–318|issn=1943-7722|doi=10.1093/ajcp/79.3.312}}</ref><ref>{{Cite journal
appear small, uniform, and round, contain
| author = [[H. Choi]], [[U. A. Almagro]], [[J. T. McManus]], [[D. H. Norback]] & [[S. C. Jacobs]]
fine evenly dispersed chromatin, and show no
| title = Renal oncocytoma. A clinicopathologic study
evidence of mitosis.1,2,7,13–15,17,19,20 A minority of
| journal = [[Cancer]]
cells can have nuclear atypia and there may be
| volume = 51
focal presence of large nucleoli, moderate to
| issue = 10
marked pleomorphism, hyperchromasia, and
| pages = 1887–1896
binucleation or multinucleation.1,2,10,15,17,20 The
| year = 1983
degree of nuclear atypia is not correlated with
| month = May
the tumor size2 and does not affect the benign
| pmid = 6831354
nature of the tumor. Accordingly, nuclear grading
}}</ref><ref>{{Cite journal
for oncocytomas has been abandoned.1,2
| author = [[M. B. Amin]], [[T. B. Crotty]], [[S. K. Tickoo]] & [[G. M. Farrow]]
Three cellular architectural patterns are commonly
| title = Renal oncocytoma: a reappraisal of morphologic features with clinicopathologic findings in 80 cases
seen (Fig. 1). The first type is described as
| journal = [[The American journal of surgical pathology]]
“organoid,”2,6 with nests of cells surrounded by a
| volume = 21
reticulin framework of thin blood vessels and
| issue = 1
strands of delicate fibrous stroma. The nests can be
| pages = 1–12
loosely arranged or packed tightly into a sheet-like
| year = 1997
appearance.1,2,6,15,17 The second pattern is tubulocystic
| month = January
or alveolar, with cells arranged as tubular
| pmid = 8990136
and cystic structures separated in a loose edematous
}}</ref><ref>{{Cite journal
stroma.1,2,15,17 The third type consists of a mixture of the organoid and tubulocystic patterns.
| author = [[J. N. Eble]] & [[M. T. Hull]]
2,17
| title = Morphologic features of renal oncocytoma: a light and electron microscopic study
Lymphovascular invasion, perinephric extension,
| journal = [[Human pathology]]
and necrosis are usually not present.1,2,15 Because
| volume = 15
such findings are so uncommon, the impact
| issue = 11
on patient prognosis is inconclusive. Such tumors
| pages = 1054–1061
are best considered “atypical oncocytomas.”
| year = 1984
Examination using Hale’s colloidal iron staining
| month = November
is often used to distinguish oncocytomas from
| pmid = 6490001
CRCC, and the results are either negative or focally
}}</ref>
positive at perinuclear, perimembranous, or apical
[[File:Renal oncocytoma HE.png|350px|none|thumb|https://openi.nlm.nih.gov/detailedresult?img=PMC3557568_rt-2012-4-e54-g003&query=renal%20oncocytoma&it=xg&req=4&npos=61]][[File:Renal oncocytoma.png|350px|none|thumb|https://openi.nlm.nih.gov/detailedresult?img=PMC3306738_1471-2369-13-9-1&query=renal%20oncocytoma&it=xg&req=4&npos=41]]
regions of the cell (Fig. 2). In CRCC, a correlation
has been found between positive Hale’s colloidal
iron staining and the presence of cytoplasmic microvesicles.3 The pattern of Hale’s colloidal iron
staining seen in oncocytomas also parallels the microvesicular
distribution.
Despite the well-characterized cytologic features
of renal oncocytomas and the obvious benefits of
the preoperative diagnosis of a benign tumor, the
role of tumor biopsy for definitive diagnosis has
been studied only retrospectively on samples taken
from surgical specimens21,22 and remains questionable.
Moreover, the overall sensitivity of renal biopsy
ranges from 40% to 90%,23–25 and many tumors
that are read as “nondiagnostic” on biopsy
are often found to be malignant after complete surgical
extirpation and thorough histologic examination.
24,25 Until the techniques and interpretations
of biopsies become more consistent, its utility for
the preoperative diagnosis of renal oncocytomas
will remain limited.
 
The “oncocyte” is the basic component of large oncocytoma.
It is a large, round, or polygonal neoplastic cell with
a granular eosinophilic cytoplasm. Oncocytic tumors were
reported outside the kidney in the thyroid, parathyroid,
salivary glands, and other tissues. With electron microscopy,
it was demonstrated that oncocytes are abundant with
mitochondria, which gives them the characteristic staining
features. Oncocytomas are arranged in nested or organoid
growth pattern [12]. Microscopic features of oncocytomas
may include cellular atypia, prominent nucleoli, and pleomorphism.
These are clearly manifestations of malignancy.
However, oncocytomas with these features maintain benign
behavior. Within the oncocytoma tumor it is possible to find
a small population of cells that exhibit cytoplasmic clearing.
This cytoplasmic clearing may also coexist in chromophobe
type RCC [6].
 
Histopathological examination carried out for hematoxylin
and eosin (HE) stained sections of tumor tissue is the first
and the most important step in the diagnostic approach to
epithelial renal neoplasms. It gives the information about
cellular, nuclear, cytoplasmic, stromal and vascular network
features as well as about growth pattern.
Renal oncocytomas are histopatologically characterized
by “oncocytes”, which by definition are large neoplastic
cells with intensely eosinophilic granular cytoplasm that
results from the large number of mitochondria. This term
was coined by Hamperl from Greek “onkousthai” and
“cyte”, to swell and cell or swelling cytoplasm.20 Oncocytomas
are found in a number of organs and have been
described previously in the thyroid gland, salivary gland,
parathyroid gland, adrenal gland and other anatomical
sites.8 The exact cell type that gives rise to an oncocytoma in
the kidney or other organs is unknown. Most pathologists
suggest a distal tubular origin for renal oncocytomas,21,22
although a proximal tubular origin was first proposed.2,23
In general, renal oncocytoma has a variable morphological
appearance. The cells are usually arranged in solid
compact nests/alveoli (acinar growth exemplar) and/or in
cords, tubules and sheets of trabeculae (tubulocystic
arrangement) that are separated by loose edematous fibrous
or hyalinised stroma (Fig. 1a). However, papillary and cystic
architecture might occur in renal oncocytomas, which might
be composed of regularly large oncocytes or small “basophilic”
cells (Fig. 1b). Recently, another aspect of two cell
types of renal oncocytoma has been discussed.24 The predominant
classic form of cells (so-called “oncocyte”) corresponds
to round-to-polygonal cells with densely granular
eosinophilic cytoplasm, round and uniform nuclei with
finely distributed chromatin, and a centrally placed prominent
nucleolus. A smaller population of cells (called
oncoblasts) has less conspicuous, paler, scanty, granular
cytoplasm, a high nuclear/cytoplasmic ratio, and dense dark
hyperchromatic, markedly pleomorphic nuclei. Bizarre,
polyploidy, enlarged nuclei, which are characteristic for
endocrine adenomas, might be scattered throughout the
renal oncocytomas, but mitoses are absent.
Summarizing the histological data, although the diagnosis
of renal oncocytoma is relatively easy in experienced hands,
difficulties might arise when this neoplasm has atypical
morphology. Additional studies, such as electron microscopy,
chromosomal analysis and immunohistochemistry,
might help in achieving a correct diagnosis.
 
==Pathogenesis==
* Renal oncocytoma is thought to arise from the [[intercalated cells]] of [[collecting ducts]] of the [[kidney]].<ref name="pmid6606945">{{cite journal |vauthors=Velasquez G, Glass TA, D'Souza VJ, Formanek AG |title=Multiple oncocytomas and renal carcinoma |journal=AJR Am J Roentgenol |volume=142 |issue=1 |pages=123–4 |year=1984 |pmid=6606945 |doi=10.2214/ajr.142.1.123 |url=http://www.ajronline.org/doi/abs/10.2214/ajr.142.1.123}}</ref>
 
*
 
 
 
==Microscopic Pathology==
* An epithelial tumor composed of oncocytes, large [[eosinophilic]] cells having small, round, benign-appearing [[nuclei]] with large [[nucleoli]] and excessive amounts of [[mitochondria]].<ref name="pmid2028856">{{cite journal |vauthors=Palmer WE, Chew FS |title=Renal oncocytoma |journal=AJR Am J Roentgenol |volume=156 |issue=6 |pages=1144 |year=1991 |pmid=2028856 |doi=10.2214/ajr.156.6.2028856 |url=http://www.ajronline.org/doi/abs/10.2214/ajr.156.6.2028856}}</ref>
 
 


==References==
==References==
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[[Category:Oncology]]
[[Category:Oncology]]
[[Category:Nephrology]]
[[Category:Nephrology]]
[[Category: Primary care]]

Latest revision as of 23:57, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2] Shanshan Cen, M.D. [3]

Overview

The exact pathogenesis of renal oncocytoma is not completely understood. Although some mechanisms are suggested in the pathogenesis of this disease that include, lossing of chromosome 1 and dysfunction of mitochondrial enzymes which is caused by alterations in the mitochondrial DNA. DNA diploidy is seen in 96% of patients with renal oncocytomas. The development of renal oncocytoma is the result of multiple genetic mutations such as deletion of chromosome 1, deletion of the sex chromosome, translocation of chromosome 11q13, sporadic or no chromosomal alteration. Renal oncocytoma can be associated with familial renal oncocytoma or Birt-Hogg-Dube syndrome. On gross pathology, tan to brown surface color , well-encapsulated with a thick, well-defined, fibrous capsule, central scar, and homogeneous appearance without any hemorrhage or necrosis inside it in the tumor cut are characteristic findings of renal oncocytoma. On microscopic histopathological analysis, renal oncocytoma characterized by "oncocytes". They are large, round to polygonal neoplastic cells accompanied by eosinophilic granular cytoplasm and are organized in nested or organoid pattern. Although, renal oncocytoma is benign, atypia, prominent nucleoli, and pleomorphism may seen in microscopic examination.

Pathophysiology

Pathogenesis

Genetics

DNA diploidy is seen in 96% of patients with renal oncocytomas.[5][6][7]

The development of renal oncocytoma is the result of multiple genetic mutations such as:[8][9][10][1][2][11]

Associated Conditions

Conditions associated with renal oncocytoma include:[12][13]

Note: Birt-Hogg-Dube syndrome is an autosomal dominant syndrome which is presented with different types of dermatologic diseases and renal epithelial tumors such as renal oncocytoma and RCCs.

Gross Pathology

On gross pathology, tan to brown surface color , well-encapsulated with a thick, well-defined, fibrous capsule, central scar, and homogeneous appearance without any hemorrhage or necrosis inside it in the tumor cut are characteristic findings of renal oncocytoma.[14][15][16][17][18][19]

https://radiopaedia.org/cases/renal-oncocytoma-gross-pathology-2?lang=us
https://radiopaedia.org/cases/renal-oncocytoma-pathology-2?lang=us

Microscopic Pathology

On microscopic histopathological analysis, renal oncocytoma characterized by "oncocytes". They are large, round to polygonal neoplastic cells accompanied by eosinophilic granular cytoplasm and are organized in nested or organoid pattern. Although, renal oncocytoma is benign, atypia, prominent nucleoli, and pleomorphism may seen in microscopic examination.[20][21][22][23][24]

https://openi.nlm.nih.gov/detailedresult?img=PMC3557568_rt-2012-4-e54-g003&query=renal%20oncocytoma&it=xg&req=4&npos=61
https://openi.nlm.nih.gov/detailedresult?img=PMC3306738_1471-2369-13-9-1&query=renal%20oncocytoma&it=xg&req=4&npos=41

References

  1. ↑ 1.0 1.1 Thrash-Bingham, Catherine A.; Salazar, Hernando; Greenberg, Richard E.; Tartof, Kenneth D. (1996). "Loss of heterozygosity studies indicate that chromosome arm 1p harbors a tumor suppressor gene for renal oncocytomas". Genes, Chromosomes and Cancer. 16 (1): 64–67. doi:10.1002/(SICI)1098-2264(199605)16:1<64::AID-GCC9>3.0.CO;2-1. ISSN 1045-2257.
  2. ↑ 2.0 2.1 Dijkhuizen, T.; van den Berg, E.; Störkel, S.; de Vries, B.; van der Veen, A.Y.; Wilbrink, M.; Geurts van Kessel, A.; de Jong, B. (1997). "Renal oncocytoma with t(5;12;11), der(1)t(1;8) and add(19): "true" oncocytoma or chromophobe adenoma?". International Journal of Cancer. 73 (4): 521–524. doi:10.1002/(SICI)1097-0215(19971114)73:4<521::AID-IJC11>3.0.CO;2-C. ISSN 0020-7136.
  3. ↑ Neuhaus, Christine; Dijkhuizen, T.; van den Berg, E.; Störkel, S.; Stöckle, M.; Mensch, B.; Huber, C.; Decker, H.-J. (1997). "Involvement of the chromosomal region 11q13 in renal oncocytoma: Case report and literature review". Cancer Genetics and Cytogenetics. 94 (2): 95–98. doi:10.1016/S0165-4608(96)00205-1. ISSN 0165-4608.
  4. ↑ C. Welter, G. Kovacs, G. Seitz & N. Blin (1989). "Alteration of mitochondrial DNA in human oncocytomas". Genes, chromosomes & cancer. 1 (1): 79–82. PMID 2487148. Unknown parameter |month= ignored (help)
  5. ↑ M. R. Licht, A. C. Novick, R. R. Tubbs, E. A. Klein, H. S. Levin & S. B. Streem (1993). "Renal oncocytoma: clinical and biological correlates". The Journal of urology. 150 (5 Pt 1): 1380–1383. PMID 8411404. Unknown parameter |month= ignored (help)
  6. ↑ J. Hartwick, R. Warren; El-Naggar, Adel K.; Ro, Jae Y.; Srigley, John R.; Mclemore, Donia D.; Jones, Edward C.; Grignon, David J.; Thomas, M. Jane; Ayala, Alberto G. (1992). "Renal Oncocytoma and Granular Renal Cell Carcinoma: A Comparative Clinicopathologic and DNA Flow Cytometric Study". American Journal of Clinical Pathology. 98 (6): 587–593. doi:10.1093/ajcp/98.6.587. ISSN 1943-7722.
  7. ↑ L. Fuzesi, B. Gunawan, S. Braun, F. Bergmann, A. Brauers, P. Effert & C. Mittermayer (1998). "Cytogenetic analysis of 11 renal oncocytomas: further evidence of structural rearrangements of 11q13 as a characteristic chromosomal anomaly". Cancer genetics and cytogenetics. 107 (1): 1–6. PMID 9809026. Unknown parameter |month= ignored (help)
  8. ↑ L. Fuzesi, B. Gunawan, S. Braun, F. Bergmann, A. Brauers, P. Effert & C. Mittermayer (1998). "Cytogenetic analysis of 11 renal oncocytomas: further evidence of structural rearrangements of 11q13 as a characteristic chromosomal anomaly". Cancer genetics and cytogenetics. 107 (1): 1–6. PMID 9809026. Unknown parameter |month= ignored (help)
  9. ↑ Presti, Joseph C.; Moch, Holger; Reuter, Victor E.; Huynh, Danh; Waldman, Frederic M. (1996). "Comparative genomic hybridization for genetic analysis of renal oncocytomas". Genes, Chromosomes and Cancer. 17 (4): 199–204. doi:10.1002/(SICI)1098-2264(199612)17:4<199::AID-GCC1>3.0.CO;2-Z. ISSN 1045-2257.
  10. ↑ van den Berg, E.; Dijkhuizen, T.; Störkel, S.; Brutel de la Rivière, G.; Dam, A.; Mensink, H.J.A.; Oosterhuis, J.W.; de Jong, B. (1995). "Chromosomal changes in renal oncocytomas Evidence that t(5;11)(q35;q13) may characterize a second subgroup of oncocytomas". Cancer Genetics and Cytogenetics. 79 (2): 164–168. doi:10.1016/0165-4608(94)00142-X. ISSN 0165-4608.
  11. ↑ R. J. Sinke, T. Dijkhuizen, B. Janssen, D. Olde Weghuis, G. Merkx, E. van den Berg, E. Schuuring, A. M. Meloni, B. de Jong & A. Geurts van Kessel (1997). "Fine mapping of the human renal oncocytoma-associated translocation (5;11)(q35;q13) breakpoint". Cancer genetics and cytogenetics. 96 (2): 95–101. PMID 9216713. Unknown parameter |month= ignored (help)
  12. ↑ G. Weirich, G. Glenn, K. Junker, M. Merino, S. Storkel, I. Lubensky, P. Choyke, S. Pack, M. Amin, M. M. Walther, W. M. Linehan & B. Zbar (1998). "Familial renal oncocytoma: clinicopathological study of 5 families". The Journal of urology. 160 (2): 335–340. PMID 9679872. Unknown parameter |month= ignored (help)
  13. ↑ J. R. Toro, G. Glenn, P. Duray, T. Darling, G. Weirich, B. Zbar, M. Linehan & M. L. Turner (1999). "Birt-Hogg-Dube syndrome: a novel marker of kidney neoplasia". Archives of dermatology. 135 (10): 1195–1202. PMID 10522666. Unknown parameter |month= ignored (help)
  14. ↑ Moch, Holger; Cubilla, Antonio L.; Humphrey, Peter A.; Reuter, Victor E.; Ulbright, Thomas M. (2016). "The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs—Part A: Renal, Penile, and Testicular Tumours". European Urology. 70 (1): 93–105. doi:10.1016/j.eururo.2016.02.029. ISSN 0302-2838.
  15. ↑ Amin, Mahul B.; Crotty, Thomas B.; Tickoo, Satish K.; Farrow, George M. (1997). "Renal Oncocytoma: A Reappraisal of Morphologic Features with Clinicopathologic Findings in 80 Cases". The American Journal of Surgical Pathology. 21 (1): 1–12. doi:10.1097/00000478-199701000-00001. ISSN 0147-5185.
  16. ↑ Perez-Ordonez, Bayardo; Hamed, Ghiath; Campbell, Steve; Erlandson, Robert; Russo, Paul; Gaudin, Paul; Reuter, Victor (1997). American Journal of Surgical Pathology. 21 (8): 871–883. doi:10.1097/00000478-199708000-00001. ISSN 0147-5185. Missing or empty |title= (help)
  17. ↑ Trpkov, Kiril; Yilmaz, Asli; Uzer, Dina; Dishongh, Kristin M; Quick, Charles M; Bismar, Tarek A; Gokden, Neriman (2010). "Renal oncocytoma revisited: a clinicopathological study of 109 cases with emphasis on problematic diagnostic features". Histopathology. 57 (6): 893–906. doi:10.1111/j.1365-2559.2010.03726.x. ISSN 0309-0167.
  18. ↑ B. Perez-Ordonez, G. Hamed, S. Campbell, R. A. Erlandson, P. Russo, P. B. Gaudin & V. E. Reuter (1997). "Renal oncocytoma: a clinicopathologic study of 70 cases". The American journal of surgical pathology. 21 (8): 871–883. PMID 9255250. Unknown parameter |month= ignored (help)
  19. ↑ F. Bertoni, C. Ferri, P. Bacchini, G. Corrado, A. Benati, D. Mannini & F. Corrado (1989). "Oncocytoma and low-grade oncocytic carcinoma of the kidney". European urology. 16 (2): 101–109. PMID 2714326.
  20. ↑ B. Perez-Ordonez, G. Hamed, S. Campbell, R. A. Erlandson, P. Russo, P. B. Gaudin & V. E. Reuter (1997). "Renal oncocytoma: a clinicopathologic study of 70 cases". The American journal of surgical pathology. 21 (8): 871–883. PMID 9255250. Unknown parameter |month= ignored (help)
  21. ↑ Barnes, C. Allan; Beckman, Edwin N. (1983). "Renal Oncocytoma and Its Congeners". American Journal of Clinical Pathology. 79 (3): 312–318. doi:10.1093/ajcp/79.3.312. ISSN 1943-7722.
  22. ↑ H. Choi, U. A. Almagro, J. T. McManus, D. H. Norback & S. C. Jacobs (1983). "Renal oncocytoma. A clinicopathologic study". Cancer. 51 (10): 1887–1896. PMID 6831354. Unknown parameter |month= ignored (help)
  23. ↑ M. B. Amin, T. B. Crotty, S. K. Tickoo & G. M. Farrow (1997). "Renal oncocytoma: a reappraisal of morphologic features with clinicopathologic findings in 80 cases". The American journal of surgical pathology. 21 (1): 1–12. PMID 8990136. Unknown parameter |month= ignored (help)
  24. ↑ J. N. Eble & M. T. Hull (1984). "Morphologic features of renal oncocytoma: a light and electron microscopic study". Human pathology. 15 (11): 1054–1061. PMID 6490001. Unknown parameter |month= ignored (help)

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