Pathology of Renal Neoplasms

Question 1

What is the most common site of renal cell carcinoma spread? How is it identified on imaging?

Answer 1

Lungs - identified by “cannonball” lesions on chext x-ray

Question 2

What is the microscopic appearance of Wilms tumor?

Answer 2

Triphasic pattern - blastemal, stromal, and epithelial cells

Question 3

What is the classic triad of symptoms associated with renal cell carcinoma?

Answer 3

Hematuria, flank pain, abdominal mass

Question 4

This benign renal neoplasm is well-circumscribed, pale yellow, and presents in the cortex with cuboidal cells.

Answer 4

Renal papillary adenoma

Question 5

Most renal cell carcinoma arises in the cortex. This type of renal cell carcinoma specifically arises in the medulla.

Answer 5

Collecting duct type renal cell carcinoma

Question 6

What is the gross appearance of renal cell carcinoma?

Answer 6

Well-circumscribed, yellow color, cystic and solid areas with focal hemorrhage

Question 7

This renal carcinoma is highly associated with tuberous sclerosis.

Answer 7

Angiomyolipoma

Question 8

This genetic condition is caused by a deletion of WT-1 on chromosome 11 and includes Wilms tumor as a symptom.

Answer 8

WAGR Syndrome (Wilms tumor, aniridia, genial anomalies, mental retardation)

Question 9

What is the most common type of renal cell carcinoma?

Answer 9

Clear cell type

Question 10

What is the gross appearance of oncocytoma?

Answer 10

Solid, mahogany brown with a central stellate scar

Question 11

Renal cell carcinoma has a propensity to invade the renal vein. This is a rare complication due to invasion of the left renal vein, blocking the spermatic vein.

Answer 11

Varicocele - this does not happen on the right as the R spermatic vein drains directly into the IVC

Question 12

This renal cancer has abundant eosinophilic cytoplasm and numerous mitochondria on EM.

Answer 12

Oncocytoma

Question 13

From where does renal cell carcinoma arise?

Answer 13

Proximal tubule cells

Question 14

What genetic mutation is most associated with clear type renal cell carcinoma?

Answer 14

Mutation of VHL gene on chromosome 3 (von Huppel-Lindau disease)

Question 15

Transitional cell carcinoma is most associated with what risk factor?

Answer 15

NSAID abuse

Question 16

This type of renal cell carcinoma has psammoma bodies and is positive for keratin 7.

Answer 16

Papillary type renal cell carcinoma

Question 17

This disease is caused by a mutation of a tumor suppressor gene on chromosome 3 that increases the risk of renal cell carcinoma.

Answer 17

Von Huppel-Lindau disease

Question 18

From what cells does renal papillary adenoma arise?

Answer 18

Rental tubular epithelium

Question 19

What genetic conditions/mutations are associated with papillary type renal cell carcinoma?

Answer 19

Trisomies 7, 16, & 17
Loss of Y in males
Mutation of MET gene on chromosome 7

Question 20

This is a rare type of renal cell carcinoma that presents with a halo surrounding the nucleus on histology.

Answer 20

Chromophobe cell renal cell carcinoma

Question 21

What symptoms are characteristic of Denys-Drash Syndrome?

Answer 21

Gonadal dysgenesis, mesangial sclerosis, gondaoblasomas, Wilms tumor

Question 22

This type of renal cell carcinoma has cells with polygonal shape and abundant cytoplasm with glycogen and lipids.

Answer 22

Clear cell type renal cell carcinoma

Question 23

What is the most common renal tumor in childhood?

Answer 23

Wilms tumor