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Presented by Dr. Pedram Argani and prepared by Dr. Yembur Ahmad
This case is about a young adult patient with a renal tumor.
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1. Question
A young adult patient presents with a renal tumor showing sinus vascular invasion. What is the diagnosis?
Correct
Answer: B
Histologic Description: The neoplasm is separated by fibrous septa which have a hyalinized appearance. The neoplastic cells have well defined cell borders and irregular nuclei with perinuclear halos. There is abundant psammomatous calcification present. The latter suggests the possibility of Xp11 translocation RCC, but can be seen in chromophobe RCC. The neoplasm demonstrated diffuse membranous labeling for CD117, supporting the diagnosis of chromophobe RCC.
Differential Diagnosis: Xp11 translocation RCC does not usually show diffuse membranous labeling for CD117, and would label for TFE3. Clear cell RCC would have more vascularized septa, and lack the prominent perinuclear halos and nuclear irregularities of this case. t(6;11) renal cell carcinomas typically have a biphasic large cell /small cell morphology, and label for melanocytic markers like Melan A.Incorrect
Answer: B
Histologic Description: The neoplasm is separated by fibrous septa which have a hyalinized appearance. The neoplastic cells have well defined cell borders and irregular nuclei with perinuclear halos. There is abundant psammomatous calcification present. The latter suggests the possibility of Xp11 translocation RCC, but can be seen in chromophobe RCC. The neoplasm demonstrated diffuse membranous labeling for CD117, supporting the diagnosis of chromophobe RCC.
Differential Diagnosis: Xp11 translocation RCC does not usually show diffuse membranous labeling for CD117, and would label for TFE3. Clear cell RCC would have more vascularized septa, and lack the prominent perinuclear halos and nuclear irregularities of this case. t(6;11) renal cell carcinomas typically have a biphasic large cell /small cell morphology, and label for melanocytic markers like Melan A.
