Cystic partially differentiated nephroblastoma

A large heterogenousheterogeneous predominantly cystic mass with an internal solid component is seen in the mid and upper part of the right kidney. The lesion also has numerous thick and thin internal septations. The soft tissue components show moderate to intense diffusion restriction.

Superiorly the lesion extends outside the kidney and compresses the liver. The IVC is compressed and mildly displaced medially. No thrombus is seen within.

PelvicalicealPelvicalyceal system of the right kidney is moderately dilated and compressed by the mass.

The right ureter is moderately dilated and contains hypointense (all sequences) components along its length.

Lobulated heterogeneous soft tissue intensity areas are seen within the right vesicoureteric junction and urinary bladder which show moderate diffusion restriction.

Histopathology report

Microscopic description

sections from the cauliflower-like growth reveal the features of a malignant tumour with the following features:

• cysts lined with flat/cuboidal/hobnail cells (or are denuded)

• epithelial elements consist mainly of mature and immature/abortive tubules and small papillae resembling immature glomeruli

• nephroblastomatous epithelial elements

• islands of undifferentiated blastema and differentiated mesenchymal elements

• focally, the septal elements protrude into the cystic spaces in microscopic papillary folds

• the growth has extended up to distal margin of ureter

• lymphovascular invasion: seen

Diagnosis

Nephroureterectomy with bladder cuff: favors, cystic partially differentiated nephroblastoma.