WSI23-38: Kidney
From MGH Learn Pathology
Request details
- Request type Study
- Subspecialty Genitourinary
- Set Genitourinary
- Topic Kidney
- Presenter Sadow, Peter M.,MD, PhD
- Date and time Saturday, April 1, 2023 12:00 PM
Toggle columns: Diagnosis
| Case | Clinical history | Requester | Diagnosis |
|---|---|---|---|
| Case | Clinical history | Requester | Diagnosis |
|
| 82 year old male with elevated creatinine shown to have left sided hydronephrosis by u/s and f/u CT yielding UPS obstruction and a mass. | Si787 | Hybrid oncocytic chromophobe tumor 5.3 cm • mid pole • confined to kidney |
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| 68 year old man with left 3.5 cm kidney mass | Si787 | Clear cell (tubulocystic) papillary renal cell carcinoma. + keratin 7 • + CA 1X-cup-like • - racemase |
|
| 53 year old male s/p Whipple and splenectomy for pancreatitis with kidney mass discovered 2° to ↑ LFTs | Si787 | Clear cell renal cell carcnioma 6.2 cm Fuhrman 3/4 + renal vein lymphovascular invasion. pT3a NX |
|
| 72 year old woman with 3.6 cm left kidney mass | Si787 | Thyroid-like follicular carcinoma of the kidney ( - TTF1 • - CA1X • - P504S • + PAX8 • - molecular ) |
|
| 40 year old woman with left kidney mass | Si787 | Epithelioid angiomyolipoma (12.6 cm)+ HMB45 • + MiTF-1 • - Melan A |
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| 71year old female with stage 4 high grade urothelial carcinoma | Si787 | Invasive high grade urothelial carcinoma (Grade 3 of 3) 8.1 cm Right renal pelvis with direct extension to adrenal with + lymph nodes |
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| 76 year old male with left kidney mass | Si787 | Metastatic high grade myxofibrosarcoma morphologically matches priors |
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| 55 year old female with left cystic renal mass | Si787 | Epithelioid clear cell neoplasm suggestive of low grade clear cell renal cell carcinoma |
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| 73 year old female with right kidney mass | Si787 | Renal cell carcinoma with predominantly rhabdoid morphology (4.6 cm). Fuhrman 4. No LVI |
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| 48 year old male with CAD • drug abuse and OSA who presented with right foot pain found to have bone lesions • mediastinal LAD. B kidney lesions • including 2.4 cm right adrenal nodule. Bx of mediastinal LAD concerig for metastatic renal cell carcinoma | Si787 | Renal cell carcioma with clear cell and spindle cell features • multifocal • up to 8.5 cm metastatic to adrenal gland (3.5 cm) + carbonic anhydrase IX |
|
| 85 year old female with renal pelvic mass infiltrating renal parenchymal with purported spread to ipsilateral adrenal gland and retroperitoneal lymph nodes | Si787 | Invasive transitinal cell carcinoma • grade 3 of 3 (5.0 cm) ++ fat • ++ angioinvasion |
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| 65 year old male with left kidney tumor | Si787 | Papillary renal cell carcioma • type I • with extensive necrosis and cystic degenerative changes |
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| 70 year old male with renal stone subsequently found to have a renal pelvis mass | Si787 | Transitional cell carcinoma (4.9 cm) grade 3 of 3 with extensive squamous differentiation and lymph node metastases (including distant-neck) |
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| 38 year old male with left kidney mass and bilateral lung lesions. | Si787 | Renal cell carcinoma • clear cell type (4.5 cm) • Fuhrman 2/4. Met RCC to lung. |
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| 63 year old male with h/o kidney tumor in 2006 and subsequent intraabdominal mass in 2012 | Si787 | 1. Papillary renal cell carcioma • type I (7.9 cm) 2. Malignant mesothelioma. |
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| 58 year old female with right kidney mass and right adrenal mass • concurrently | Si787 | Kidney: Renal cell carcioma • cler cell type (2.5 cm). Fuhrman 1/4 (pTla). Adrenal: Adrenal corticaladenoma (2.6 cm). |
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| 45 year old male with a complex resection of the left adrenal • kidney • spleen and pancreas | Si787 | L kidney: Papillary renal cell carcinoma • type I. L adrenal: metastatic large cellneuroendocrie carcinoma • favor GI primary |
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| 72 year old male with left renal mass | Si787 | Papillary renal cell carcinoma • type I (4.5 cm) • Fuhrman grade 2 of 4 |
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| 24 year old male with Sickle trait • African-American with 8.6 cm left kidney mass and known distant metastases | Si787 | Renal medullary carcinoma |
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| 55 year old male with history of right renal mass with gross involvement of the inferior vena cava • liver and bowel | Si787 | Clear cell renal cell carcinoma with rhabdoid and anaplastic morphology (15 cm) Fuhrman grade 4 of 4 with mets |
|
| 45 year old male with left upper tract filling defect | Si787 | Urothelial hyperplasia with atypia • favor reactive |
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| 85 year old with left renal pelvis mass and large superior pole lesion with presumptive adrenal and retroperitoneal mets who presents with hematuria. | Si787 | Invasive TCC grade 3 of 3 • arising in association with CIS • pTCC 3/3 with extensive hilar LVI and parenchyma involvement |
|
| 61 year old female with right renal mass | Si787 | Chromophobe renal cell carcinoma (5.7 cm) superior pole • confined to kidney |
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| 73 year old female with right renal mass | Si787 | Oncocytoma (2.2 cm) |
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| 53 year old female with 2 cm mid pole left renal mass and complex 4.9 lower pole mass | Si787 | Low grade RCC c/w chromophobe RCC. Other is cystic clear cell |
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| 49 year old female with left RCC • clear cell • now with right lesion of kidney and abdominal mass | Si787 | A. Angiolipoma • focally epithelioid. B. Cystic RCC • clear cell type. C. Angiolipoma |
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| 61 year old male with exophytic right midpole renal mass with hemorrhage by imaging thought to be a hemorrhagic cyst | Si787 | Cystic RCC • clear cell type (5.5 cm). Fuhrman grade 2/4. Two papillary adenomas |
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| 66 year old morbidly obese male with poorly controlled DM • HT • nodular liver and ~ 10 cm kidney mass | Si787 | RCC • clear cell type (9.0 cm) Fuhrman grade 3/4 with LVI and extension into perirenal fat |
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| 41 year old female with h/o fibrosarcoma of right thigh in 2003 now with mass I right kidney (2.0 cm) | Si787 | Chromophobe RCC 2/4 completely excised |
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| 24 year old female who presented at age 18 with painless lump lateral right knee s/p two resections now with kidney mass | Si787 | Metastatic osteosarcoma (10.5 cm) with mixed osteoblastic • fibroblastic and chondroblastic features involving the renal vein |
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| 80 year old male with right renal mass. | Si787 | Renal cell carcinoma • clear cell type (5.2 cm) papillary type I (4.2 cm) with a tubular pattern |
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| 7 year old male with h/o tuberous sclerosis and polycystic kidney disease | Si787 | Papillary renal cell • multiple type II and type I angiolipoma • PCKD (contiguous gene detection syndrome) |
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| 2 year old Haitian male with 17 cm intraabdominal mass | Si787 | Nephroblastoma (Wilms tumor) 17 cm mixed type (intermediate risk) |
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| 65 year old female who presents with RL pole 2.7 complex • enhancing lesion previously bx with dx | Si787 | Papillary renal cell carcioma • type I with extensive necrosis • adrenal cortical nest |
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| 64 year old female with FNA of inferior kidney pole mass → pap Rcc and 1 cm superior pole mass | Si787 | Superior pole → RCC • clear cell type (1.0 cm). Inferior pole atypical oncocytic neoplasm (3.2 cm) with papillary fx (oncocytic papillary RCC vs oncocytoma) |
|
| 61 year old male with mild renal insufficiency discovered to have a 5.5 cm cystic mass on ultrasound | Si787 | Renal cell carcinoma • clear cell type with cytic degenerative changes and necrosis |
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| 64 year old male with left lower pole renal mass (6.0 cm) with 3 additional gross lesions at excision • one (0.6 cm) in upper pole and two in the middle | Si787 | Renal cell carcinoma • clear cell type (6.0 cm). Renal cell carcinoma • papillary type I (0.6 cm). Papillary adenomas (two • 0.2 cm each) |
|
| 63 year old male with painless gross hematuria X 2 weeks | Si787 | Renal cell carcinoma • cler cell type (7.2 cm). RCC & CD10+ • CK7- • CD117- • TFE 3 focal |
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| 33 year old female with multiple kidney lesions and a large cyst. Biopsy of one lesion | Si787 | Angiomyolipoma |
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| 2 year old male with large abdominal mass | Si787 | Nephroblastoma (17 cm) (Wilms tumor) • mixed type with extensive mesodermal differentiation |
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| 73 year old male with a 10.5 cm kidney tumor | Si787 | Renal cell carcinoma • eosinophilic chromophobe type (10.5 cm) • Fuhrman grade 3 of 4 |
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| 55 year old male with h/o right renal mass with inferior vena cava and liver involvement | Si787 | Clear cell renal cell carcinoma with largely rhabdoid and anaplastic-type morphology (15 cm) • Fuhrman grade 4 of 4 • invading the renal vein and IVC. + Liver • + Colon • + IVC |
|
| 1 year old female with left upper pole of kidney ectopic ureterocele | Si787 | Consistent with ureterocele renal dysplasia • partial |
|
| 55 year old male with right upper pole kidney mass. | Emw8 | Chromophobe renal cell carcinoma 8.1 cm. |
