Renal cell carcinoma

Case contributed by Dr Andrew Ryan

Presentation

Flank pain

Patient Data

Age: 55

Left kidney - coronal section

Modality: Pathology

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

Modality: 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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