Renal cell carcinoma

Case contributed by Dr Andrew Ryan

Presentation

Flank pain

Patient Data

Age: 55
Pathology

Left kidney - coronal section

The photo shows a left kidney bisected in the coronal plane.

Pathology

Histological sections confirmed clear cell renal cell carcinoma (RCC) with tumour cells containing abundant, predominantly cleared cytoplasm. Clear cell RCC is graded according to presence/size of nuceoli (nucleolar grading) +/- nuclear morphology (Fuhrman grading), with a final grade based on the highest grade area. 

Case Discussion

This is a nice example of clear cell renal cell carcinoma that demonstrates several aspects of the tumour;

  • Classical yellow/golden macroscopic appearance.
  • Propensity to grow into the renal vein, sometimes extending into the inferior ven cava and right ventricle.
  • Cells classically have clear cytoplasm; this is actually a processing artifact secondary to removal of the cytoplasmic lipid during processing.
  • Often has marked variation in tumour cell morphology and grade across the tumour; this is attributed to 'clones' of tumour cells arising out the initial tumour clone. 
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Case information

rID: 36892
Case created: 15th May 2015
Last edited: 27th Sep 2015
System: Urogenital
Inclusion in quiz mode: Excluded

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