GPR: 2020 - Week 30

From MGH Learn Pathology

Clinical history

A 52-year-old male, status post left nephrectomy >30 years ago for an atrophic left kidney, with an incidentally discovered 5.5 cm cystic right kidney mass


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Tubulocystic Renal Cell Carcinoma
-Rare kidney tumor featuring tubular and cystic architectural growth

-Well-circumscribed, unifocal -Spongy “bubble wrap” appearance -Variable-sized cysts contain clear serous fluid -Range: 0.2-17 cm (4.2 cm average)

-Recurrent losses at ch 9 and gains at ch 17
 

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Multilocular Cystic Clear Cell Renal Cell Neoplasm of Low Malignant Potential

-Renal neoplasm composed of clear cell-lined cysts

-Well circumscribed, often with fibrous pseudocapsule -Marked variation in cyst size

-No solid or expansile masses are present in tumor
 

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Clear Cell Renal Cell Carcinoma with cystic change

-Typically show golden-yellow cut surfaces

-Areas featuring necrosis, fibrosis, cystic change, hemorrhage are common

-Some cases show prominent cystic changes. Extensive sampling to identify solid may be required
 

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Cystic Nephroma

-In adults, considered to be within the mixed epithelial and stromal tumor family

-Pediatric lesions: associated with DICER1 gene mutations -Well circumscribed with a capsule -Diffusely cystic with clear serous fluid contents

-Solid areas may represent sarcomatous transformation
 
Alex Subtelny

This week's Gross Pathology Roundup was presented by Lucas Massoth, MD on Mon, Jul 20, 2020.