Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by William Westra, M.D. and prepared by Orin Buetens, M.D.
Case 6: 58 year old male with a renal mass.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- Answered
- Review
-
Question 1 of 1
1. Question
Week 13: Case 6
58 year old male with a renal mass.
Correct
Answer: Chromophobe carcinoma
Histology: The lesion consists of solid sheets of cells with areas of tubular differentiation. There are two cell types within the mass. One cell type has a pale appearance and consists of cells with abundant pale lightly eosinophilic granular cytoplasm with prominent cell borders. The other cell type has a more eosinophilic appearance. Many cells have transitional appearances between those that are more clear and those that are more granular. Nuclei varies from those that are round to those that are larger and more irregular. Many of the nuclei have a prominent perinuclear halo. Binuclear cells are not uncommonly seen.
Discussion: Oncocytomas can resemble chromophobe renal cell carcinoma with a prominent eosinophilic cellular component. In oncocytomas the cytoplasm is densely eosinophilic and lacks the pale appearance seen within many of the cells in the current case. In oncocytomas, the nuclei are round, although they may show prominent nucleoli. They lack the nuclear irregularity and binucleation seen within chromophobe renal cell carcinomas. The cell borders in oncocytomas are not as distinct and the nuclei lack perinuclear halos in contrast to chromophobe renal cell carcinoma. In some cases, it may be difficult to distinguish the two and stains for Hale’s colloidal iron may differentiate these lesions. Chromophobe renal cell carcinomas stain intensely and diffusely for Hale’s colloidal iron whereas oncocytomas particularly are negative or show luminal staining within some of the tubules. The architectural pattern of oncocytoma also differs from chromophobe renal cell carcinoma in that oncocytomas typically consist of nests or tubules floating within an edematous stroma and lacks large areas of sheets of cells which may be seen in chromophobe renal cell carcinoma. In contrast to clear cell carcinoma, the cells within chromophobe renal cell carcinoma are not purely optically clear but rather have a very fine granular lightly eosinophilic appearance. The term “granular renal cell carcinoma” is no longer preferred. The tumors with a granular appearance may represent any number of renal cell carcinoma subtypes including “clear cell renal cell carcinoma” papillary renal cell carcinoma, and chromophobe renal cell carcinoma.
Incorrect
Answer: Chromophobe carcinoma
Histology: The lesion consists of solid sheets of cells with areas of tubular differentiation. There are two cell types within the mass. One cell type has a pale appearance and consists of cells with abundant pale lightly eosinophilic granular cytoplasm with prominent cell borders. The other cell type has a more eosinophilic appearance. Many cells have transitional appearances between those that are more clear and those that are more granular. Nuclei varies from those that are round to those that are larger and more irregular. Many of the nuclei have a prominent perinuclear halo. Binuclear cells are not uncommonly seen.
Discussion: Oncocytomas can resemble chromophobe renal cell carcinoma with a prominent eosinophilic cellular component. In oncocytomas the cytoplasm is densely eosinophilic and lacks the pale appearance seen within many of the cells in the current case. In oncocytomas, the nuclei are round, although they may show prominent nucleoli. They lack the nuclear irregularity and binucleation seen within chromophobe renal cell carcinomas. The cell borders in oncocytomas are not as distinct and the nuclei lack perinuclear halos in contrast to chromophobe renal cell carcinoma. In some cases, it may be difficult to distinguish the two and stains for Hale’s colloidal iron may differentiate these lesions. Chromophobe renal cell carcinomas stain intensely and diffusely for Hale’s colloidal iron whereas oncocytomas particularly are negative or show luminal staining within some of the tubules. The architectural pattern of oncocytoma also differs from chromophobe renal cell carcinoma in that oncocytomas typically consist of nests or tubules floating within an edematous stroma and lacks large areas of sheets of cells which may be seen in chromophobe renal cell carcinoma. In contrast to clear cell carcinoma, the cells within chromophobe renal cell carcinoma are not purely optically clear but rather have a very fine granular lightly eosinophilic appearance. The term “granular renal cell carcinoma” is no longer preferred. The tumors with a granular appearance may represent any number of renal cell carcinoma subtypes including “clear cell renal cell carcinoma” papillary renal cell carcinoma, and chromophobe renal cell carcinoma.
