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Presented by Dr. Pedram Argani and prepared by Dr. Tricia Cottrell
This is a 3 week old female with two renal tumors, 5 and 3cm each.
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Question 1 of 1
1. Question
This is a 3 week old female with two renal tumors, 5 and 3cm each.
Correct
Answer: B
Histology: This is active proliferation of primitive nephroblastic elements, including abundant blastemal cells, primitive epithelial tubules and glomeruli. The lesion has an unencapsulated border and directly abuts the benign renal tubules. Thin fibrous septa separate lobules of the lesion. These are the typical features of hyperplastic perilobar nephrogenic rest.
Discussion: A favorable histology Wilms tumor is distinguished from hyperplastic nephrogenic rest by the presence of a fibrous capsule and its spherical shape (as opposed to the unencapsulated ovoid nature of hyperplastic rests). Anaplastic Wilms tumor would demonstrate hyperchromatic enlarged nuclei with atypical mitotic figures, and would be extremely unlikely at this young age. Neuroblastoma would not demonstrate the primitive tubules and glomeruli seen in the current lesion.
Incorrect
Answer: B
Histology: This is active proliferation of primitive nephroblastic elements, including abundant blastemal cells, primitive epithelial tubules and glomeruli. The lesion has an unencapsulated border and directly abuts the benign renal tubules. Thin fibrous septa separate lobules of the lesion. These are the typical features of hyperplastic perilobar nephrogenic rest.
Discussion: A favorable histology Wilms tumor is distinguished from hyperplastic nephrogenic rest by the presence of a fibrous capsule and its spherical shape (as opposed to the unencapsulated ovoid nature of hyperplastic rests). Anaplastic Wilms tumor would demonstrate hyperchromatic enlarged nuclei with atypical mitotic figures, and would be extremely unlikely at this young age. Neuroblastoma would not demonstrate the primitive tubules and glomeruli seen in the current lesion.
