Renal

Question 1

Seminoma

Answer 1

OCT3/4, CD117, D2-40, SALL4
Elevated LDH and rarely hCG

Question 2

Embryonal carcinoma

Answer 2

OCT3/4, CD117, PLAP, SALL4, CD30, AE1/AE3

Question 3

Syncytiotropoblasts

Answer 3

Inhibin, glypican-3

Question 4

Cytotrophoblasts

Answer 4

SALL4, p63,GATA3

Question 5

Yolk sac tumor

Answer 5

AFP, glypican-3, SALL4, AE1/AE3

Question 6

Leydig tumor

Answer 6

Rare cases have fumarate hydratase gene mutation.
Inhibin-alpha and STAR to differentiate between germ cell tumor.
SF1 is a sex cord tumor marker.
Calretinin, Melan-A (MART1) and CD99.
P53 positive in malignant cases.

Question 7

Sertoli cell tumor

Answer 7

Cells look like plant cells, clear cells or in tubules. Can have a prominent hyalin fibrosis. Produce estrogen.
Inhibin-alpha, SF1, calretinin, melan-A, CD99
Nuclear beta catenin so CTNNB1 gene mutation.

Question 8

Prostate

Answer 8

TMPRSS2-ERG (Temptress)
SNP
BRACA2
TP53
PTEN

Question 9

Malakoplakia

Answer 9

Bulls eye histiocytes called Michaelis-Gutmann bodies.
Von Kossa and Prussian blue highlights cells.
PAS stains histiocytes.

Question 10

Focal segmental glomerulosclerosis

Answer 10

Idiopathic:
Adults associated with elevated suPAR.
Children associated with podocin mutation.
African American, non diabetic APOL1 gene mutated.

Question 11

LCAT

Answer 11

Lecithin cholesterol acyltransferase responsible for forming lipoprotein cholesterol esters.

Question 12

FABREY

Answer 12

Deficiency of galactosidase A resulting in glycospingolipidiosis.

Question 13

Papillary RCC

Answer 13

PAX8, CK7, AMACR, vimentin and CD10
Negative for CDIX

Question 14

Oncocytoma

Answer 14

Britt-Hogg-dube syndrome
CK7, CD117, S100, E-cadherin
Negative for vimentin and CAIX

Question 15

Chromophobe

Answer 15

CK7, CD117, parvalbumin, hale colloid iron.

Question 16

Clear cell papillary RCC

Answer 16

CK7, CAIX cup shaped, GATA3, PAX8, HMWCK
NEG: AMACR, CD10