Renal tumors Renal tumors Dr. Abdelaty Shawky Dr. Gehan MohamedDr. Abdelaty Shawky Dr. Gehan Mohamed

2. Papillary RCC2. Papillary RCC

* Clinical Features:

•Comprises about 10% to 15% of all RCCs.

•More likely to be bilateral or multiple than other

RCCs

•Significantly better outcome than that of the

clear cell type.

* Gross Pathology:

•Solitary, well-circumscribed cortical mass.

•Necrosis and hemorrhage are common.

•More likely to be bilateral or multifocal than

other RCCs.

* Histopathology:

•Papillae and tubulopapillary structures with

fibrovascular cores.

•Foamy histiocytes expanding the papillary cores

and Psammoma bodies are characteristic.

3. Chromophobe RCC3. Chromophobe RCC

* Clinical Features:

•About 5% of RCCs

•Significantly better prognosis than clear cell

RCC.

* Gross Pathology:

•Solitary, spherical, well-circumscribed mass.

•Homogeneous, tan or light-brown cut surface.

* Histopathology:•The cells have finely reticulated pale cytoplasm with prominent cell membrane

4. Collecting duct carcinoma4. Collecting duct carcinoma

* Clinical Features:

•Rare, comprising about 0.1% of RCCs.

•Flank mass, pain, and hematuria.

•One third have metastasis at presentation.

* Gross Pathology:

•Medullary location.

•Light-gray, white cut surface with invasive

borders.

•Necrosis, hemorrhage, and cystic changes may

be present.

* Histopathology:•Highly infiltrative border

•Tubular and tubulopapillary structures

surrounded by Inflamed desmoplastic stroma.

•The cells show high-grade atypia.

Staging of RCCStaging of RCC

Wilms tumor (nephroblastoma)Wilms tumor (nephroblastoma)

* Clinical Features:•Common solid tumor of childhood; 90% found before the age of 6 years with peak incidence at the ages 2 to 5 years.•Rarely found in adults or neonates.•Patients usually present with an abdominal mass or abdominal tenderness; may present with hematuria, hypertension, or rarely peritoneal symptoms if spontaneous rupture has occurred•Treatment includes surgical resection, chemotherapy and radiation

* Gross Pathology:

•Typically single, well-circumscribed mass with

lobulated appearance.

•The cut surface is variegated, bulging, pale-gray

to tan-pink typically with extensive hemorrhage

and necrosis; cyst formation may be seen

* Histopathology:

•Classically shows triphasic pattern consisting of

blastemal, stromal, and epithelial components

•Blastemal component is arranged in diffuse sheets or

thin cords or as nodular aggregates;

•Blastema consists of small, round cells with

hyperchromatic nuclei showing coarse chromatin and

scant cytoplasm

Wilms tumor

Wilms tumor (nephroblastoma)

References:Robbins and Cotran’s:

Pathologic Basis of Disease. Seventh edition.