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Renal tumors

Renal tumors . Dr. Abdelaty Shawky Dr. Gehan Mohamed. 2. Papillary RCC. * Clinical Features: Comprises about 10% to 15% of all RCCs . More likely to be bilateral or multiple than other RCCs Significantly better outcome than that of the clear cell type. * Gross Pathology:

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Renal tumors

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  1. Renal tumors Dr. Abdelaty Shawky Dr. Gehan Mohamed

  2. 2. Papillary RCC * Clinical Features: • Comprises about 10% to 15% of all RCCs. • More likely to be bilateral or multiple than other RCCs • Significantly better outcome than that of the clear cell type.

  3. * Gross Pathology: • Solitary, well-circumscribed cortical mass. • Necrosis and hemorrhage are common. • More likely to be bilateral or multifocal than other RCCs.

  4. * Histopathology: • Papillae and tubulopapillary structures with fibrovascular cores. • Foamy histiocytes expanding the papillary cores and Psammomabodies are characteristic.

  5. 3. Chromophobe RCC * Clinical Features: • About 5% of RCCs • Significantly better prognosis than clear cell RCC.

  6. * Gross Pathology: • Solitary, spherical, well-circumscribed mass. • Homogeneous, tan or light-brown cut surface.

  7. * Histopathology: • The cells have finely reticulated pale cytoplasm with prominent cell membrane

  8. 4. Collecting duct carcinoma * Clinical Features: • Rare, comprising about 0.1% of RCCs. • Flank mass, pain, and hematuria. • One third have metastasis at presentation.

  9. * Gross Pathology: • Medullary location. • Light-gray, white cut surface with invasive borders. • Necrosis, hemorrhage, and cystic changes may be present.

  10. * Histopathology: • Highly infiltrative border • Tubular and tubulopapillarystructures surrounded by Inflamed desmoplasticstroma. • The cells show high-grade atypia.

  11. Staging of RCC

  12. Wilms tumor (nephroblastoma)

  13. * Clinical Features: • Common solid tumor of childhood; 90% found before the age of 6 years with peak incidence at the ages 2 to 5 years. • Rarely found in adults or neonates. • Patients usually present with an abdominal mass or abdominal tenderness; may present with hematuria, hypertension, or rarely peritoneal symptoms if spontaneous rupture has occurred • Treatment includes surgical resection, chemotherapy and radiation

  14. * Gross Pathology: • Typically single, well-circumscribed mass with lobulated appearance. • The cut surface is variegated, bulging, pale-gray to tan-pink typically with extensive hemorrhage and necrosis; cyst formation may be seen

  15. * Histopathology: • Classically shows triphasic pattern consisting of blastemal, stromal, and epithelial components • Blastemalcomponent is arranged in diffuse sheets or thin cords or as nodular aggregates; • Blastemaconsists of small, round cells with hyperchromaticnuclei showing coarse chromatin and scant cytoplasm

  16. Wilms tumor

  17. Wilms tumor (nephroblastoma)

  18. References: Robbins and Cotran’s: Pathologic Basis of Disease. Seventh edition.

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