mSlide 132.nRenal cell carcinoma, Kidney

A. Brief DescriptionsG

  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 FindingsG

  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 FindingsG

  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. ReferenceG

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

 

 

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

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i Fig. 132-2 (4X)jTumor exhibits clear appearnce.

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i Fig. 132-3 (10X)jClear cytoplasm due to high contain of lipid & glycogen.

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i Fig. 132-4 (40X)jClear cytoplasm due to high contain of lipid & glycogen..

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