《Slide 132.》Renal cell carcinoma, Kidney

A. Brief Descriptions：

1. Tumors arise from tubular epithelial cells; Tobacco is the most prominent risk factor; often in older; preponderance in men.

2. Classic symptoms: hematuria, loin pain & mass.

3. Classification of RCC: clear cell (nonpapillary) carcinoma (70% to 80%) ; papillary carcinoma(10% to 15%); chromophobe renal carcinoma (5%).

B. Gross Findings：

1. Protruding from renal cortex, as an irregular, bosselated mass, expansile growth with compressing adjacent renal parenchyma into a pseudocapsule. Cut surface often hemorrhagic, grayish white to yellow, and cystic change or necrosis.

C. Micro Findings：

1. Clear cell:

   • Clear cytoplasm due to high contain of lipid & glycogen.

   • Prominent cell borders and  tightly adherent to neighboring cells.

2. Granular cell: pink granular cytoplasm due to high content of mitochondria.

3. Arrange in sheets, nests, cords, tubular or papillary pattern with a fine capillary vascular background, and separated by fibrous septi.

4. Little cellular or nuclear pleomorphism or mitosis.

5. Necrosis, fibrosis, cholesterol deposit ( may with foreign body reaction), hemorrhage, calcification or cystic change.

D. Others:

1. Peak at sixth decade, male 2-3 times more frequently than female ; higher incidence in Jews.

E. Reference：

1. Robbins Pathologic Basis of Disease, 6^th ed.  p.991-994

 

 

【 Fig. 132-1 (2X)】Tumor mass is seen left field and normal architecture is seen in right view in this scanning field.

　

 

 

【 Fig. 132-2 (4X)】Tumor exhibits clear appearnce.

　

 

 

【 Fig. 132-3 (10X)】Clear cytoplasm due to high contain of lipid & glycogen.

　

 

 

【 Fig. 132-4 (40X)】Clear cytoplasm due to high contain of lipid & glycogen..