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Presented by Pedram Argani, M.D. and prepared by Priya Banerjee, M.D.
Case 1: 4 year old male with a renal tumor.
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Question 1 of 1
1. Question
Week 360: Case 1
4 year old male with a renal tumorimages/8_4_08 1A.jpg
images/8_4_08 1B.jpg
images/8_4_08 1C.jpgCorrect
Answer: Wilms tumor (Nephroblastoma)
Histology: This is a triphasic lesion. The lesion consist of neoplastic bland spindle cells set in a myxoid stroma, small round blue cells clustered together constituting blastema, and focal areas of tubule formation. This is the characteristic histopathology of Wilms tumor (Nephroblastoma).
Discussion: Clear cell sarcoma would lack the areas of blastema and tubule formation seen in the current lesion. Primitive Neuroectodermal Tumor would feature rosettes, but would lack true tubule formation, or spindle cell foci. Congenital Mesoblastic Nephroma typically occurs in younger children, and lacks the blastemal or tubular growth patterns seen in the current case.
This Wilms tumor nicely demonstrates invasion of the renal sinus vasculature. These are the blood vessels and lymphatics which constitute the major lymphovascular drainage of the kidney, and invasion of them is sufficient to upstage the tumor to COG stage II.
Incorrect
Answer: Wilms tumor (Nephroblastoma)
Histology: This is a triphasic lesion. The lesion consist of neoplastic bland spindle cells set in a myxoid stroma, small round blue cells clustered together constituting blastema, and focal areas of tubule formation. This is the characteristic histopathology of Wilms tumor (Nephroblastoma).
Discussion: Clear cell sarcoma would lack the areas of blastema and tubule formation seen in the current lesion. Primitive Neuroectodermal Tumor would feature rosettes, but would lack true tubule formation, or spindle cell foci. Congenital Mesoblastic Nephroma typically occurs in younger children, and lacks the blastemal or tubular growth patterns seen in the current case.
This Wilms tumor nicely demonstrates invasion of the renal sinus vasculature. These are the blood vessels and lymphatics which constitute the major lymphovascular drainage of the kidney, and invasion of them is sufficient to upstage the tumor to COG stage II.
