Collecting duct carcinoma is a diagnosis of exclusion. Before making it, look for a urothelial carcinoma in situ or papillary component in the renal pelvis on the resection, and include urothelial markers such as GATA3 and p63 on the panel. Also consider fumarate hydratase-deficient renal cell carcinoma and metastatic adenocarcinoma, which can mimic it. Communicate uncertainty clearly when only a biopsy is available.
- Sample the renal pelvis carefully for an in situ or papillary urothelial component.
- Include GATA3 and p63 in the panel for an infiltrative tubular renal carcinoma.
- Consider fumarate hydratase immunostaining before diagnosing collecting duct carcinoma.
- Exclude metastatic adenocarcinoma clinically and immunohistochemically.
Why it matters
A wrong call between these tumours sends the patient down a different treatment pathway.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for pathology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free