Images hosted on other servers:
Solid mass
expanding to
collecting system
Mid kidney
gray-white mass
Contributed by Maria Tretiakova, M.D., Ph.D.
ALK-RCC in adult patient
Mixed solid and papillary areas with abundant mucin
Infiltrating growth with desmoplasia
Eosinophilic discohesive pleomorphic cells
ALK
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ALK break apart probe with split signals
Karyotype,
metaphase and
interphase FISH
RT-PCR with VCL exon 16 and ALK exon 20
EML4-ALK and
TPM3-ALK
gene fusion points
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US & CT scan
Contributed by Maria Tretiakova, M.D., Ph.D.
Solid and cystic hemorrhagic neoplasm
Contributed by Nicole Andeen, M.D., Maria Tretiakova, M.D., Ph.D., Gregory T. MacLennan, M.D. and @katcollmd on Twitter
Papillary architecture
Oxalate crystals
Acquired cystic disease associated renal cell carcinoma
Images hosted on other servers:
Ultrasound
CT
Contributed by Bonnie Choy, M.D.
Well circumscribed, multicystic mass
Multilocular cystic mass
Contributed by Bonnie Choy, M.D.
Multicystic tumor
Flat and hobnail epithelium
Hobnail epithelium
Cuboidal epithelium
Stroma with variable cellularity
ER
PR
PAX8
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FNA
Contributed by Erdener Özer, M.D., Ph.D.
Tumor with solid and cystic parts
Contributed by Maria Laura Galluzzo Mutti, M.D. and Gordan M. Vujanic, M.D., Ph.D.
Spindled pattern
Alternating cellularity
Blastema-like area
Diffuse anaplasia
Benign cartilage
Malignant cartilage
Anaplasia
Cystic nephroma-like areas
Cystic pattern
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CT with renal mass
Contributed by Tatjana Antic, M.D.
Classic variant
Predominant adipose tissue
Fat poor
Hemorrhagic angiomyolipoma
Cystic epithelioid angiomyolipoma with hemorrhage
Contributed by Tatjana Antic, M.D. and Ankur R. Sangoi, M.D. (Case #359)
Classic
Epithelioid
Fat poor
Epithelial cysts (AMLEC)
Sclerosis
SMA
HMB45
Contributed by AFIP and @katcollmd on Twitter
Tan and relatively homogeneous tumor
Chromophobe RCC
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Yellowish brown tumor with granular cut surface
Nodular tumor with focal hemorrhage and necrosis
Contributed by Maria Tretiakova, M.D., Ph.D., Daniel Anderson, M.D., M.B.A. and @katcollmd on Twitter
Solid sheets and thin septae
Large polygonal and smaller eosinophilic cells
Raisinoid nuclei
Plant-like membranes and binucleation
Plant-like cells
Pale reticular cells
Discohesive
Confluent growth
Chromophobe renal cell carcinoma
Sarcomatoid
Hale colloidal iron
CK7
KIT
Vimentin
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Two cell populations
Polygonal plant-like cells
Large round to oval cells (Diff-Quik)
Pap stain
AFIP images
Cytoplasmic vesicles of 150 - 300 nm
Paranuclear cytoplasmic vesicles
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Homogenous enhancement, multifocal calcifications
Contributed by Timothy Isaac Miller, M.D., M.A. and Maria Tretiakova, M.D., Ph.D.
Nephrectomy with ChRCC eosinophilic variant
Contributed by Timothy Isaac Miller, M.D., M.A. and Maria Tretiakova, M.D., Ph.D.
Mild cytological atypia
Prominent perinuclear clearing
Alveolar architecture
Focal classic cells
Increased cytological atypia
Extension to perinephric fat
Distinguishing eosinophilic chromophobe RCC from oncocytoma
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Left sided mass (CT scan)
Contributed by Gregory T. MacLennan, M.D. and Behtash Nezami, M.D.
Involving Gerota fascia (pT4)
Confined T1b
Multifocal
In renal vein
Invading sinus fat and pelvicalyceal system
Variegated cut surface
Cystic changes
Contributed by Gregory T. MacLennan, M.D., Behtash Nezami, M.D., Nicole K. Andeen, M.D. and Maria Tretiakova, M.D., Ph.D.
Sinusoidal vasculature
Micro and macrocysts
With renal capsule invasion
ISUP grade 1
ISUP grade 2
ISUP grade 3
ISUP grade 4
In renal vein
In perirenal fat
Sarcomatoid
Sarcomatoid
Rhabdoid differentiation
Rhabdoid and sarcomatoid areas
Necrosis
Heterotopic bone formation
Clear cell RCC could have areas of eosinophilic cytoplasm mimicking other RCC sybtypes
Intramural granulomatous reaction
Involving pelvicalyceal system (pT3a)
CD10 IHC staining
CAIX IHC staining
Sarcomatoid, pancytokeratin
Contributed by Gregory T. MacLennan, M.D.
FNA cytology
FNA high grade
Contributed by Behtash Nezami, M.D.
Genetic alterations
Contributed by Gregory MacLennan, M.D.
Partial nephrectomy specimens
Acquired cystic kidney disease
Contributed by Gregory MacLennan, M.D. and @katcollmd on Twitter
Overall architecture
Papillary architecture
Tubular architecture
Low grade nuclear features
Clear cell papillary renal cell tumor
Clear cell papillary renal cell tumor
CAIX
CK7
CD10
AMACR
AFIP images
Age distribution of 156 cases
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Clear cell sarcoma
Large tan to tannish yellow tumor
Contributed by Maxwell Rollins, M.D.
Various images
AFIP images
3rd Series, Vol. 11
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Small oval cells
Clear and spindle cells, fibrovascular septas
Renal mass
Renal mass in a 19 month old boy
EGFR+
Contributed by Maxwell Rollins, M.D.
Touch prep
AFIP images
Fine needle aspiration
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Morphological patterns
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MRI, T2 and T1 weighted
Contributed by Daniel Anderson, M.D., M.B.A. and Debra L. Zynger, M.D.
Involving kidney and pelvis
Partially necrotic
Large tumor
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Infiltrative gray-white tumor
Tumor invades renal capsule and infiltrates adipose tissue
Contributed by Daniel Anderson, M.D., M.B.A. and Garrison F. Pease, M.D.
Adjacent renal parenchyma
Architecture
Infiltrative border
Prominent nucleoli
Tumor and nonneoplastic
Tumor tubules and cords
Cellular details
Cellular and nuclear details
Border tumor and nonneoplastic
Possible dysplastic tubule epithelium
Collecting duct carcinoma
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Large renal mass
Upper pole mass
CT large mass
Contributed by Ellen D’Hooghe, M.D., Gordan M. Vujanic, M.D., Ph.D. and Case #57
Classic type
Mixed type
Cellular type
Contributed by Ellen D’Hooghe, M.D. and Gordan M. Vujanic, M.D., Ph.D.
Classic type
Classic type vessels
Entrapped normal renal parenchyma
Extramedullary hematopoiesis
Islands of cartilage
Cellular type
Cellular type
Single entrapped tubule
Tumor-kidney interface
Mixed type
Sinus invasion
Perirenal fat invasion
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Ultrasonography of multilocular cystic mass
MRI of multilocular cystic mass
Abdominal CT with bilateral CPDN
Contributed by Americo Brilhante, M.D. and Daniel Athanazio, M.D., Ph.D.
Multilocular cyst of the kidney
Contributed by Americo Brilhante, M.D. and Daniel Athanazio, M.D., Ph.D.
Multilocular cystic tumor
Nephroblastomatous elements
Transition between tumor and renal cortex
Fibrous septa and epithelial lining
Small tubules with hobnail morphology
Abortive / immature tubules
Abortive / immature tubules
Primitive blastema and tubules
AE1 / AE3
WT1
Contributed by Maria Tretiakova, M.D., Ph.D.
TCEB1 mutated RCC
CAIX
CK7
CD10
Clear cell RCC with TCEB1-like features
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TCEB1 mutations and HIF accumulation
TCEB1 mutated RCC with monosomy 8
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Circumscribed,
solid tumor with
gray-tan to brown
cut surface
Contributed by Maria Tretiakova, M.D., Ph.D.
Vessels at periphery
Solid nested growth pattern
Entrapped tubules
Clear vacuolated to granular cytoplasm
High grade nuclei
KIT
Cathepsin K
CD10
CK7
Vimentin
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Dilated cisterns of RER and numerous mitochondria
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mTOR mediated pathways
Contributed by Doreen Palsgrove, M.D.
CT abdomen and pelvis
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CT and MRI with gross specimen
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Nephrectomy
Contributed by Doreen Palsgrove, M.D. and @katcollmd on Twitter
Solid growth
Abundant cytoplasm
Basophilic cytoplasmic inclusions
CK20
Eosinophilic, solid and cystic renal cell carcinoma
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Copy number alterations
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Potential pathogenesis
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CT, MRI
Case with TSC
Large renal mass
Heterogeneous mass
Contributed by Judy Sarungbam, M.D.
Circumscribed, pink-tan mass
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Circumscribed, lobulated cut surface
Contributed by Anil Parwani, M.D., Ph.D., M.B.A.
Diffuse growth
Cytologic and nuclear features
Cytologic features
Carcinoma-like growth pattern
Cytologic features
MelanA
HMB45
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Tumor cells with premelanosomes
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Molecular analysis of TFE3 gene
TSC2 mutation
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Proposed
mechanisms of
tumorigenesis
in HLRCC
Consequences
of elevated
cellular
fumarate
TCA cycle enzyme
Contributed by Debra Zynger, M.D., Nicole K. Andeen, M.D. and Maria Tretiakova, M.D., Ph.D.
FH deficient RCC
FH
CAIX
PAX8
HLRCC with
tubulopapillary
growth and
eosinophilic cells
HLRCC with pale
eosinophilic cytoplasm
and inclusion-like
nucleoli
Uterine leiomyoma
from a patient
with HLRCC, with
multinucleation
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Findings in patient with HLRCC and RCC
HLRCC renal tumors
Clear cell RCC
Uterine leiomyomas in HLRCC
2SC IHC shows
diffuse and strong
reactivity in HLRCC
renal cancer
2SC IHC shows
cytoplasmic staining
pattern in a few
unclassified RCC
Contributed by Maria Tretiakova, M.D., Ph.D.
Renal sinus invasion (pT3)
Contributed by Maria Tretiakova, M.D., Ph.D.
Positive margin, invasion of ureter
Coagulative tumor necrosis
RCC in fat (pT3)
RCC in fat, microscopic invasion
RCC involving a vein (pT3)
RCC involving renal vein margin (pT3)
RCC metastasis to bronchus (pM)
RCC metastasis to stomach (pM)
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Heterogeneous
enhancing mass;
unevenly increased
FDG uptake
Well defined heterogenous lesion
Bilateral inhomogeneous lesions
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Well defined pale mass
Myxoid areas
Contributed by Maria Tretiakova, M.D., Ph.D.
Capsule and nests
Small uniform tumor cells
Abundant vasculature
Rare mitotic figure
Positive SMA
Positive collagen IV
Negative S100
Contributed by Debra L. Zynger, M.D.
Basal lamina
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Thin microfilament, dense bodies
Contributed by Maria Tretiakova, M.D., Ph.D.
Small, dark nuclei
Nucleoli are barely visible
Nucleoli are easily seen
Large pleomorphic nuclei
Sarcomatoid differentiation
Anaplastic giant and rhabdoid cells
Anaplastic giant cells
Nonanaplastic giant cells
Dual low and high grade RCC
Contributed by Debra Zynger, M.D.
RCC, clear cell type
RCC, papillary type 2
RCC, clear cell papillary type
RCC, chromophobe type
Oncocytoma
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Left kidney mass
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Well demarcated tumor
Contributed by Maria Tretiakova, M.D., Ph.D.
Lipoblast-like cells
Nuclear pleomorphism
Capillary network
Spindle tumor cells
Inhibin positive
CAIX positive
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Kidney ultrasound
Noncontrast CT
Contrast CT
Contributed by Maria Tretiakova, M.D., Ph.D. and AFIP images
Cavernous hemangioma
Hypocellular AH
Anastomosing hemangioma
Sinusoidal anastomosing pattern
Fibrin thrombi (AH)
Extramedullary hematopoiesis
CD31 (AH)
Renal hemangioma
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Heterogenous pattern
Stellate central hypodensity
2 abutting tumors
Preoperative CT
Contributed by Bonnie Choy, M.D.
Multiple tan-brown tumors
Contributed by Chin-Lee Wu, Ph.D. and Maria Tretiakova, M.D., Ph.D.
Dual population of eosinophilic cells
BHD related hybrid tumor
Contributed by Roula Albadine, M.D. and Julie Guilmette, M.D.
Oncocytic tumor cells
Oncocytic cells with granular eosinophilic cytoplasm
Hale colloidal iron
Contributed by Bonnie Choy, M.D.
Touch preparation
Images hosted on other servers:
CT
MRI
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Well circumscribed, solid cut surface
Encapsulated
Hemorrhage and hemosiderin deposition
Contributed by Sean Williamson, M.D. and Matthew Wasco, M.D. (Case #467)
Glomoid appearance
Papillary architecture
Prominent vasculature
Polygonal to spindle cells
Contributed by Alcino Pires Gama, M.D.
Normal juxtaglomerular apparatus
Contributed by Sean Williamson, M.D. and Matthew Wasco, M.D. (Case #467)
Rhomboid shaped renin protogranules
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Ultrasound and CT
CT
CT
CT
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Solid, tan-white mass
Whorled, bulging cut surface
Contributed by Alcino Pires Gama, M.D. and Bonnie Choy, M.D.
Intersecting fascicles
Bland spindle cells
h-caldesmon
SMA
Contributed by Garrison Pease, M.D.
Well circumscribed tumor
Contributed by Garrison Pease, M.D. and Maria Tretiakova, M.D., Ph.D.
Solid with boats in a bay pattern
Boats in a bay and low grade cytomorphology
Solid pattern and low grade cytomorphology
Solid with boats in a bay pattern
Solid with boats in a bay pattern
Solid with boats in a bay pattern
Solid compact component
CD117 / KIT negative
CK7 positive expression
CK7 positive expression
CD117 / KIT negative expression
GATA3 positive expression
Vimentin negative
Cathepsin K negative
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Homogenous solid mass, no calcification or necrosis
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Largely solid, tan homogenous renal mass
Fibrous, white grey cut surface
White solid and cystic cut surface
Contributed by Rose Chami, M.D.
Biphasic tumor with epithelial and stromal components
Highly cellular tumor
Tubular and glomeruloid structures
Psammoma bodies
Cellular solid appearance
Spindle cell component
AE1/AE3
WT1, both components
WT1, epithelial component
WT1, stromal component
CD34, both components
BRAF V600E, epithelial component
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CT scan
Contributed by Debra L. Zynger, M.D.
Partial nephrectomy
Radical nephrectomy
Contributed by Tatjana Antic, M.D. and @katcollmd on Twitter
Well circumscribed
Scar
Calcifications
Packed tubules
Loose stroma
Mitotic figure
Pseudopapillary
Pseudopapillary and glomeruloid
Metanephric adenoma
Metanephric adenoma
BRAF
WT1
Contributed by Ellen D’Hooghe, M.D. and Gordan M. Vujanic, M.D., Ph.D.
Solid and cystic tumor with hemorrhage
Contributed by Ellen D’Hooghe, M.D. and Gordan M. Vujanic, M.D., Ph.D.
Nodularity
Alternating cellularity
"Onion skinning"
Cysts
Intratubular growth
Angiodysplasia
Tumor - kidney interface
CD34
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Metastatic oral squamous cell carcinoma
Metastatic phyllodes tumor
Contributed by Debra Zynger, M.D.
Lung squamous cell carcinoma
Images hosted on other servers:
Myeloma
Small cell lung cancer
Solitary fibrous tumor
Contributed by Maria Tretiakova, M.D., Ph.D., Nicole K. Andeen, M.D.
Breast carcinoma
Gastric carcinoma
Well differentiated neuroendocrine tumor
Images hosted on other servers:
MRI
Contributed by Bonnie Choy, M.D.
Solitary, well circumscribed
Mixed solid and cystic
Contributed by Bonnie Choy, M.D. and @katcollmd on Twitter
Predominantly cystic area
Predominantly solid area
Hypocellular stroma
Hypercellular stroma
Cuboidal epithelium
Hobnailed epithelium
Mixed epithelial and stromal tumor
ER
PR
CD10
PAX8
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Isodense mass in the renal medulla
Hyperintensity on T2 weighted image
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Cut surface with focal hemorrhage
Contributed by J. Cody Craig, M.D., Aida Valencia, M.D., Jennifer B. Gordetsky, M.D. and @katcollmd on Twitter
Bland tubules and spindle cells
Whorled tubules
Bland cuboidal and spindle cells
Compact tubules
Elongated tubules
Bland spindle cells
Mucinous tubular and spindle cell carcinoma
PAX8
CK7
p504s / AMACR
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Most common genetic alterations
SNP array analysis
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Pure multilocular cystic mass
Contributed by Maria Tretiakova, M.D., Ph.D.
Cortical multilocular cystic tumor
Irregular tumor pushing into renal hilum
Contributed by Maria Tretiakova, M.D., Ph.D. and @ahmsab_MD on Twitter
Variably sized cysts with low grade clear cell lining
Variably sized cysts with low grade clear cell lining
renal neoplasm
of low malignant
potential
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Large renal mass
Renal mass
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Intraoperative appearance
Contributed by Ellen D’Hooghe, M.D. and Gordan M. Vujanic, M.D., Ph.D.
Encapsulated tumor
Lobulated tumor
Necrotic tumor
Postchemotherapy tumor
Extrarenal growth of tumor
Multifocal tumor
Contributed by Ellen D’Hooghe, M.D. and Gordan M. Vujanic, M.D., Ph.D.
Blastemal component
Epithelial component
Squamous epithelium
Undifferentiated stroma
Differentiated stroma
Adipose tissue
Mature cartilage
Subtotally necrotic tumor
"Dying" blastema
Chemotherapy induced changes
Anaplasia
Focal anaplasia
Pseudoanaplasia
Renal sinus involvement
Tumor thrombus
Perirenal fat invasion
Lymph node metastasis - viable
Lymph node metastasis - nonviable
Resection margin - nonviable tumor
Incompletely resected tumor
Case of the Week #338
Various images
AFIP images
Intralobar
Intralobar nephrogenic rest
Neoplastic intralobar rest
Nephroblastomatosis
Perilobar
Microscopic rests composed of blastemal cells, are termed "incipient" in neonates and "dormant" otherwise
Sclerosing perilobar nephrogenic rest
Focal scarring
Hyperplastic perilobar rest in sclerosing stage
Multifocal hyperplastic perilobar rests
Nearly confluent rind of perilobar rest tissue; thick rind of perilobar tissue
Neoplastic perilobar rest
Case of the Week #338
Various images
Contributed by Ian W. Gibson, M.B.Ch.B., M.D.
Kimmelstiel-Wilson nodules, hyaline arteriolosclerosis
Nodular hyaline arteriolosclerosis
Organized atheromatous embolism
Tubular neutrophilic casts
Monotonous dense small lymphocytes
AFIP images
Renal oncocytoma
MRI shows same tumor with prominent central scar
Contributed by Debra Zynger, M.D.
Tan, central scar
Pale brown, central scar
Pale brown, central scar
Mahogany
Congested, dark brown
Hemorrhagic, red
Contributed by Rola Saleeb, M.D., Ph.D.
Small nested morphology
Degenerated cells
Loose stroma
c-KIT
CK7
Hale colloidal iron
Contributed by Maria Tretiakova, M.D., Ph.D.
Compact, nested
Central scar
Nested, cystic
Lack of prominent membranes
Oncoblasts (20x)
Degenerate atypia
Edematous stroma
Microcystic, hobnailed
Atypia multinucleation
Fat extension
Rosettes
Vascular extension
S100A1
CK7
AFIP images
Abundant granular cytoplasm
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Small clusters and single cells with uniform cytoplasm
Diff-Quik shows
homogeneous granular
cytoplasm and round, regular
nuclei without grooves
AFIP images
Cytoplasm is packed with large mitochondria
Images hosted on other servers:
FISH: loss of chromosomes 1 and 17
Contributed by Ellen D’Hooghe, M.D. and Gordan M. Vujanic, M.D., Ph.D.
Polypoid / pedunculated calcified mass
Contributed by Ellen D’Hooghe, M.D. and Gordan M. Vujanic, M.D., Ph.D.
Osteoid and cellular components
Osteoid component
Cellular component
Vimentin+
WT1+
AE1 / AE3-
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Hypoenhacing lesion on CT
CT scan upper pole tumor
Contributed by Nicole K. Andeen, M.D. and Maria Tretiakova, M.D., Ph.D.
Granular cut surface
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Circumscribed tumor with extensive hemorrhage
Encapsulated tumor with hemorrhage and necrosis
Tumor with capsular invasion
Tan-pink mass with satellite nodules
Renal vein extension
Contributed by Rola Saleeb, M.D., Ph.D., Vincent Francis Castillo, M.D., Nicole K. Andeen, M.D.,
Maria Tretiakova, M.D., Ph.D., Semir Vranić, M.D., Ph.D. and @SueEPig on Twitter
Circumscribed mass
Papillary architecture
Low grade PRCC
PRCC with foamy histiocytes and hemosiderin
Foamy macrophages
PRCC with clear cytoplasm
High grade PRCC
High grade eosinophilic cells
Pseudosolid pattern
Psammoma bodies
Tubulopapillary architecture
PRCC with low grade morphology
PRCC with high grade morphology
Papillary renal cell carcinoma
Encapsulated PRCC
Solid growth
Glomeruloid growth pattern
Biphasic pattern
Cyclin D1
AMACR positive
CK7 focally positive
Retained FH expression
Contributed by Debra L. Zynger, M.D.
Papillary structures and foamy histiocytes
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Foamy macrophages
Papillary tissue fragment
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MRI of renal adenomatosis
AFIP images
1.5 cm subcapsular tumor
Contributed by Rola Saleeb, M.D., Ph.D. and Vincent Francis Castillo, M.D.
No fibrous capsule
Tubulopapillary architecture
Subcapsular location
Small unencapsulated tumor
Cytoplasmic clearing
Foamy histocytes
Hemosiderin pigments
Basophilic scant cytoplasm
CK7
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Chromosome 12 trisomy
Contributed by Nicole K. Andeen, M.D.
Papillary renal cell carcinoma with oncocytic cells
Contributed by Nicole K. Andeen, M.D. and Maria Tretiakova, M.D., Ph.D.
Papillary type 1 oncocytic renal cell carcinoma
Contributed by Semir Vranić, M.D., Ph.D., University of Sarajevo (Bosnia)
Oncocytic "variant" of papillary renal cell carcinoma
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Racemase, CD10, vimentin, MET
Contributed by Hsin-Yi Chang, M.D. and Jen-Fan Hang, M.D.
Hyperintense in T1 weighted MRI
Hypointense in T2 weighted MRI
Isoechoic mass under ultrasound
Contributed by @katcollmd on Twitter
Papillary renal neoplasm with reverse polarity
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Courtesy of Katrina Collins, M.D.
In polycystic kidney disease
Delicate papillae
Contributed by Hsin-Yi Chang, M.D., Jen-Fan Hang, M.D., @ahmsab_MD on Twitter and @katcollmd on Twitter
Partially cystic growth
Papillary pattern
Tubulopapillary pattern
Stromal hyalinization
Low grade inverted nuclei
Type D papillary adenoma
GATA3
Papillary renal neoplasm with reverse polarity
Papillary renal neoplasm with reverse polarity
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Ultrasonography and CT of abdomen
Well circumscribed, huge CN in the right kidney
Contributed by Daniel Anderson, M.D., M.B.A.
Bulging mass
Multicystic
Thin septa and fine vasculature
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Specimen after nephrectomy
Contributed by Daniel Anderson, M.D., M.B.A.
Cystic nephroma
Adjacent renal parenchyma
Cystic nephroma flat
Cuboidal, hobnail, flat
Cystic nephroma with hobnailing
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DICER1 protein domains and mutations
Pediatric renal tumors: molecular diagnostics and COG updates
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Noncontrast coronal CT with 5.7 cm mass
Noncontrast axial CT with 2.5 cm mass
Postcontrast axial CT without evidence of enhancement
Coronal and axial (contrast) CT scans
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Partially cystic, hemorrhagic mass
Multiloculated cystic mass
Contributed by Maria Tretiakova, M.D., Ph.D.
Atrophic appearance
Variably sized follicles
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Giemsa
Uniform, medium sized cells
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EWSR1::PATZ1 schematic
Contributed by Rajal B. Shah, M.D., Ph.D.
Clear cell renal tumors
IHC of clear cell renal tumors
Contributed by Jean-François Aita, M.D.
Large clear cell RCC
2 small RCCs
RCC with venous invasion
Cystic Bosniak 4 RCC
Multilocular cystic renal carcinoma
Contributed by Debra Zynger, M.D. and AFIP
pT2b
pT3a
pT4
Tumor less than 3 cm
Arising in adult type polycystic renal disease
Diffusely infiltrative
Massive tumor extension
Metastases to small intestine
Nodal metastases
Retrograde extension of tumor
Contributed by Maria Tretiakova, M.D., Ph.D., Miruna Claudia Popescu, M.D. and Katrina Collins, M.D.
Clear cell RCC histology
Papillary RCC histology
Chromophobe RCC histology
FH deficient RCC histology
SDH deficient RCC histology
RCC metastatic to stomach
RCC metastatic to bronchus
RCC metastatic to duodenum
Box-like CAIX in CCRCC
CK7 positivity in PRCC
AMACR positivity in PRCC
Vimentin positivity in PRCC
CD10 positivity in PRCC
CD117 in chromophobe RCC
CK7 in chromophobe RCC
Vimentin in chromophobe RCC
Hale colloidal iron in ChRCC
PAX8 in FH deficient RCC
FH loss
PAX8 in SDH deficient RCC
SDHB loss
AFIP images
Cells in alveolar arrangement
Pathology resident led live unknown slide session: pink renal tumors (part 1)
A dummies guide to diagnosis of renal tumors using pattern based approach by Dr. Rajal B. Shah
A dummies guide to diagnosis of clear renal tumors by Dr. Rajal B. Shah
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Incidental tumor
Contributed by Andrew McLoughlin, M.S., Debra L. Zynger, M.D. and AFIP
Small, white nodule
Multiple small tumors
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Firm, well circumscribed tumor
White tumor
Contributed by Eduardo Eyzaguirre, M.D.
Medullary based tumor
Small stellate cells
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Rhabdoid component is solid, white
Contributed by Nicole K. Andeen, M.D.
Discohesive rhabdoid cells with eccentrically placed nuclei, prominent nucleoli and densely eosinophilic cytoplasm
Abrupt transition between conventional clear cell carcinoma and rhabdoid morphology
Rhabdoid cells express CAIX, similar to coexistent conventional clear cell component
Contributed by @SueEPig on Twitter
Adult renal cell carcinoma - rhabdoid variant
- Not relevant to this topic
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10 cm kidney mass
- Not relevant to this topic
Images hosted on other servers:
Solid to cystic renal mass
Rhabdoid component is solid, white
Contributed by Rola Saleeb, M.D., Ph.D., Nicole K. Andeen, M.D. and @SueEPig on Twitter
Solid sheet pattern
Rhabdoid cells
CCRCC with rhabdoid areas
Rhabdoid cells in renal vein
Discohesive rhabdoid cells
Clear cell carcinoma and rhabdoid morphology
Adult renal cell carcinoma - rhabdoid variant
Adult renal cell carcinoma - rhabdoid variant
Pancytokeratin positive
EMA negative
CAIX positive
CD10 positive
Rhabdoid cells express CAIX
- Not relevant to this topic
- Not relevant to this topic
- Not relevant to this topic
Contributed by Ellen D’Hooghe, M.D. and Gordan M. Vujanic, M.D., Ph.D.
Solid, fleshy tumor
Contributed by Ellen D’Hooghe, M.D. and Gordan M. Vujanic, M.D., Ph.D.
Classic pattern
Classic pattern associated with eosinophils
Hypercellular tumor
Entrapped normal renal tubules
Epithelioid pattern
Intracytoplasmic
inclusions
Lymphomatoid pattern
Sclerosing pattern
Prominent sclerosing pattern
Spindling growth pattern
Pseudoalveolar pattern
Loss of nuclear INI1
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Redox alterations
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Cystic change;
solid neoplasms
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Various images
SDH deficient RCC
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Proposed pathogenesis model
Morphologic patterns
Contributed by Daniel Anderson, M.D., M.B.A.
Medulla centered mass
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Well circumscribed yellowish white tumor
Focally infiltrative
Lobulated tumor
Contributed by Daniel Anderson, M.D., M.B.A. and @katcollmd on Twitter
Cribriform, reticular and nested growth
Cribriform nest
Reticular growth
Nuclear details
SMARCB1 deficient renal medullary carcinoma
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Loosely cohesive groups
Pathology mini tutorial of renal medullary carcinoma
Cytomorphologic study of renal medullary carcinoma involving serous cavity fluids
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Signalling pathways involved in EMT reported in sRCC
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MRI
CT with large renal mass
PET / CT with widespread disease
Contributed by Daniel Anderson, M.D., M.B.A.
Heterogeneous white mass
White mass arising from ccRCC
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ccRCC with
sarcomatoid
differentiation
Contributed by Daniel Anderson, M.D., M.B.A.
Sarcomatoid spindle cell differentiation
Atypical pleomorphic spindle cells
Pleomorphic sarcomatoid cells
Atypical spindled and giant cells from a ccRCC
Sarcomatoid differentiation in ccRCC
Rhabdoid cells are not sarcomatoid
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4 variable risk stratification
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Ultrasound, heterogeneous hyperechoic mass
CT, heterogeneous enhancing mass
MRI, heterogeneous mass
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Tumor deforming right kidney
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Yellow-tan mass
Rubbery white-tan mass
Adipose tissue and hemorrhage
Contributed by Maria Tretiakova, M.D., Ph.D.
Patternless architecture
Staghorn vessels
Necrosis
Entrapped tubules
STAT6
CD34
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SFTs with low risk of aggressive behavior
SFTs with high risk of aggressive behavior
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Structure of NAB2::STAT6
NAB2::STAT6 gene fusion
Contributed by Debra Zynger, M.D.
Clear cell RCC (pT1a)
Clear cell papillary RCC (pT1a)
ACDA RCC (pT1a)
Clear cell RCC (pT1b)
Chromophobe RCC (pT1b)
Papillary type 2 RCC (pT2a)
Chromophobe RCC (pT2a)
Papillary RCC (pT2b)
Clear cell RCC (pT3a)
Clear cell RCC (pT3b)
Clear cell RCC (pT4)
Contributed by Debra Zynger, M.D.
Renal sinus fat invasion (pT3a)
Perinephric fat invasion (pT3a)
Renal vein invasion (pT3a)
Pelvicaliceal invasion (pT3a)
Direct extension to adrenal (pT4)
Periaortic lymph node metastasis (pN1)
Bone metastasis (pM1)
Lung metastasis (pM1)
Ovary metastasis (pM1)
Stomach metastasis (pM1)
Contributed by Maria Tretiakova, M.D., Ph.D. and Debra L. Zynger, M.D.
Solid tumor
Cystic tumor
Contributed by Maria Tretiakova, M.D., Ph.D.
Classic triad
Cell blistering
Psamomma bodies
TFE3 rRCC mimicking CCPRCT
Papillary and alveolar growth pattern
CCPRCT
pRCC
TFEB renal cell carcinoma
TFE3 positive IHC
MiT family translocation renal cell carcinoma by Rajal Shah, M.D.
Contributed by Maria Tretiakova, M.D., Ph.D. and Debra L. Zynger, M.D.
Solid tumor
Cystic tumor
Contributed by Maria Tretiakova, M.D., Ph.D.
Classic triad
Cell blistering
Psamomma bodies
TFE3 rRCC mimicking CCPRCT
Papillary and alveolar growth pattern
CCPRCT
pRCC
TFEB renal cell carcinoma
TFE3 positive IHC
MiT family translocation renal cell carcinoma by Rajal Shah, M.D.
Contributed by Debra Zynger, M.D. (Case #484) and Daniel Anderson, M.D.
Creamy, soft mass
Partial nephrectomy
Contributed by Maria Tretiakova, M.D., Ph.D., Sabrina Sopha, M.D. and Debra Zynger, M.D. (Case #484)
Tubules and variably sized cysts lined by cuboidal epithelium
Hobnailing and distinct nucleoli
Cysts and tubules lined by cuboidal epithelium with scattered hobnailing
Numerous cysts
Hobnailed lining
Rigid cysts
Nucleoli
Small tubules
Cytoplasmic CD10, CK7 and EMA positivity
Fumarate hydratase
PR
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Sheets of cells with well defined borders
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Type I and type II cells
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Loss of chromosome 9 and gain of chromosome 17
Loss of the Y chromosome in the lining epithelial cells
Tubulocystic renal cell carcinoma
by Dr. Rajal Shah
Contributed by Nicole K. Andeen, M.D. and Maria Tretiakova, M.D., Ph.D.
Unclassified RCC
Contributed by Nicole K. Andeen, M.D. and Maria Tretiakova, M.D., Ph.D.
Unclassified RCC CDC-like
Unclassified RCC
Initially unclassified RCC (chromophobe)
Initially unclassified RCC (clear cell)
ISUP presents: reporting of MRI guided prostate biopsies
by Dr. Jennifer Gordetsky
ISUP presents: maximizing the impact of renal mass biopsy
by Dr. Sara Wobker
ISUP presents: emerging WHO entities in renal neoplasia
by Dr. Ondrej Hess
Contributed by Maria Tretiakova, M.D., Ph.D.
ALK rearranged renal cell carcinoma
Eosinophilic solid and cystic renal cell carcinoma
ELOC (formerly TCEB1) mutated renal cell carcinoma
Fumarate hydratase deficient renal cell carcinoma
Macronucleoli
Low grade oncocytic tumor
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Overall and disease specific survival by histology
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Right renal mass
Enhancing right renal mass
Tumor extending into inferior vena cava
Cystic tumor
Slightly hyperdense tumor
Metastases on DOTATATE scan
CT and MRI showing left renal mass in a horseshoe kidney
Contributed by Jennifer Jeung, M.D. (Case #204)
Tan, soft, well encapsulated mass in lower pole
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Tumor in horseshoe kidney
Renal mass with hemorrhage
Necrotic renal mass
Tumor involving sinus fat
Cystic renal mass
Contributed by Maria Tretiakova, M.D., Ph.D., Leandro Freitas, M.D., Ana Grizotto, M.D., Athanase Billis, M.D.,
the Genitourinary Pathology Society (Case #521) and Sleiman Khalil, M.D.
Well demarcated tumor
Nests and pseudoglands
Monotonous tumor cells
Classic appearance
Prominent stroma
Areas of solid growth
Gland-like lumina
Positive synaptophysin
Positive chromogranin
Positive CD99
Synaptophysin, chromogranin, CAM5.2
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Monotonous cells
Positive synaptophysin stain
Granular cytoplasm
Contributed by Jennifer Jeung, M.D. (Case #204)
TEM of tumor cells
Prominent neurosecretory granules
Amin: 2022
Cheng: 2019
Eble: 2022
Fatima: 2019
IARC: 2022
Jennette: 2023
Jiang: 2023
Lara: 2015
Pritchard-Jones: 2015
Tickoo: 2015
VandenBussche: 2022
Wobker: 2021
Yang: 2020
Zhou: 2022
Zhou: 2022
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