Difference between revisions of "mgh:cyto-1-12"

From MGH Learn Pathology
 
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== Basic Cytomorphology ==
 
== Basic Cytomorphology ==
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'''Normal renal cells – N13-7430'''|
'''Normal renal cells – N13-7430'''
 
 
* Proximal Convoluted Tubule (PCT): tubules and sheets, abundant granular cytoplasm, ill-defined fragile cytoplasm without cell borders (unlike oncocytoma)
 
* Proximal Convoluted Tubule (PCT): tubules and sheets, abundant granular cytoplasm, ill-defined fragile cytoplasm without cell borders (unlike oncocytoma)
 
* Bland nucleus, prominent nucleolus, mimics: oncocytoma, RCC
 
* Bland nucleus, prominent nucleolus, mimics: oncocytoma, RCC
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* Smaller cells, no vacuoles (unlike RCC)
 
* Smaller cells, no vacuoles (unlike RCC)
 
* No nucleolus, mimic: RCC
 
* No nucleolus, mimic: RCC
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'''Glomeruli – N12-9686'''
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'''Glomeruli – N12-9686'''|
 
* Capillary loops best seen on the periphery of the cell group
 
* Capillary loops best seen on the periphery of the cell group
 
* Very cellular, spindled and round cells in a crowded structure, the glomeruli may retain their round shape or may be drawn out into an irregular or ovoid shape during smearing
 
* Very cellular, spindled and round cells in a crowded structure, the glomeruli may retain their round shape or may be drawn out into an irregular or ovoid shape during smearing
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* No spherules or papillae (unlike papillary RCC)
 
* No spherules or papillae (unlike papillary RCC)
 
* Beware of a smear containing both glomeruli and tubules, the radiologist may have missed the lesion or the abnormality seen on imaging may * be non-neoplastic
 
* Beware of a smear containing both glomeruli and tubules, the radiologist may have missed the lesion or the abnormality seen on imaging may * be non-neoplastic
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'''Renal cell carcinoma – C94-1636'''
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'''Renal cell carcinoma – C94-1636'''|
 
* Clear Cell Type (CRCC): clean or necrotic background
 
* Clear Cell Type (CRCC): clean or necrotic background
 
* Cohesive monolayered sheets or crowded groups with a mixture of cells with granular cytoplasm and cells with clear or finely vacuolated cytoplasm (clear cells may be in the minority) (unlike oncocytoma)
 
* Cohesive monolayered sheets or crowded groups with a mixture of cells with granular cytoplasm and cells with clear or finely vacuolated cytoplasm (clear cells may be in the minority) (unlike oncocytoma)
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* Papillary RCC:  small unform cells with scant basophilic cytoplasm (type 1) or more abundant eosinophilic cytoplasm (type 2) in three dimensional spheres or in papillae with cores containing foamy histiocytes; tumor cells and histiocytes may contain hemosiderin
 
* Papillary RCC:  small unform cells with scant basophilic cytoplasm (type 1) or more abundant eosinophilic cytoplasm (type 2) in three dimensional spheres or in papillae with cores containing foamy histiocytes; tumor cells and histiocytes may contain hemosiderin
 
* Impox: AMACR, CD10, RCC positive; CK7 positive more often in type 1 than type 2
 
* Impox: AMACR, CD10, RCC positive; CK7 positive more often in type 1 than type 2
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'''Oncocytoma – N13-6827'''
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'''Oncocytoma – N13-6827'''|
 
* Dyshesive single cells or loose clusters
 
* Dyshesive single cells or loose clusters
 
* round nuclei, smooth borders  (but occasional nuclear atypia)
 
* round nuclei, smooth borders  (but occasional nuclear atypia)
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* Vimentin Negative, Cytokeratin 8/18 Positive
 
* Vimentin Negative, Cytokeratin 8/18 Positive
 
* Hale's Colloidal Iron Negative, or Perinuclear/atypical Staining Present, MIMICS: PCT, Chromophobe RCC, Conventional RCC with Granular Cytoplasm
 
* Hale's Colloidal Iron Negative, or Perinuclear/atypical Staining Present, MIMICS: PCT, Chromophobe RCC, Conventional RCC with Granular Cytoplasm
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Latest revision as of 15:41, July 2, 2020


Indications for Kidney Fine Needle Aspiration Cytology/Biopsy

Procuring the specimen
Processing the specimen
Report

Kidney FNA- Management

Basic Cytomorphology

Normal renal cells – N13-7430
Glomeruli – N12-9686
Renal cell carcinoma – C94-1636
Oncocytoma – N13-6827