ACKD-RCC-like cysts

Definition: Acquired cystic disease-associated renal cell carcinoma (ACKD-RCC), originally described by Tickoo and colleagues, is found exclusively in patients with end-stage renal disease.

Tickoo and colleagues noted: "Many of the tumors (16 of 24 dominant tumors) appeared to arise in a cyst, most often completely filling the cystic space. The cells lining such cysts were morphologically similar to those in the rest of the tumor."

Atypical cysts lined with vacuolated cells with eosinophilic cytoplasm that are likely the earliest precursors of ACKD-RCC. When these cysts are encountered, especially ones that are multilocular or clustered, they may be misdiagnosed as ACKD-RCC.

ACKD-RCC-like cysts should be recognized as a distinct entity from ACKD-RCC, defined by the lack of any solid nodular growth within the cyst.

Paywall references

 Acquired Cystic Disease-associated Renal Cell Carcinoma (ACKD-RCC)-like Cysts. Sun Y, Argani P, Tickoo SK, Epstein JI. Am J Surg Pathol. 2018 Jul 11. doi : 10.1097/PAS.0000000000001124 PMID: 30001236