Difference between revisions of "Kidney tumours"

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Kidney tumours (view source)

Revision as of 03:52, 4 November 2013

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→‎Renal oncocytoma: split-out
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==Renal oncocytoma==
==Renal oncocytoma==
===General===
{{Main|Renal oncocytoma}}
*Can be difficult to distinguish radiologically from RCC (chromophobe subtype).
** ... and pathologists occasionally struggle like the radiologists.
*Benign tumour - the reason it is excised is... one cannot be certain it isn't a RCC.
 
===Gross===
*Brown, mahogany brown.
*1/3 have a characteristic central scar.<ref name=Ref_GUP302>{{Ref GUP|302}}</ref>
 
====Image====
<gallery>
Image:Renal_oncocytoma.jpg| Renal oncocytoma with central scar. (WP)
</gallery>
===Microscopic===
Features:
*Eosinophilic cytoplasm - slightly granular '''key feature'''.
*Cells arranged in nests.
*Nuclei uniform and round.<ref name=Ref_GUP302>{{Ref GUP|302}}</ref>
**Slightly enlarged nuclei, but '''no significant''' pleomorphism (size variation) - '''important'''.
 
Notes:
*May look like eosinophilic variant of chromophobe RCC -- this is the main DDx.
**A comparison based on histomorphology: ''[[Kidney_tumours#Tabular_comparison_of_oncocytoma_and_chromophobe_RCC|Tabular comparison between ChRCC & oncocytoma]]''.
***Oncocytoma typically has: no perinuclear clearing, no raisinoid nuclei, no binucleation.
 
DDx:
*[[Chromophobe renal cell carcinoma]], eosinophilic variant.
*[[Clear cell renal cell carcinoma]], eosinophilic variant.
 
====Images====
<gallery>
Image:Renal_oncocytoma2.jpg | Oncocytoma - high mag. (WC/Nephron)
Image:Renal_oncocytoma3.jpg | Oncocytoma - intermed. mag. (WC/Nephron)
Image:Renal_oncocytoma4.jpg | Oncocytoma - low mag. (WC/Nephron)
</gallery>
===Stains===
*[[Hale's colloidal iron]] -ve
**[[ChRCC]] +ve (blue granular cytoplasmic).
 
===IHC===
*CK7 -ve<ref name=pmid17683191>{{Cite journal  | last1 = Liu | first1 = L. | last2 = Qian | first2 = J. | last3 = Singh | first3 = H. | last4 = Meiers | first4 = I. | last5 = Zhou | first5 = X. | last6 = Bostwick | first6 = DG. | title = Immunohistochemical analysis of chromophobe renal cell carcinoma, renal oncocytoma, and clear cell carcinoma: an optimal and practical panel for differential diagnosis. | journal = Arch Pathol Lab Med | volume = 131 | issue = 8 | pages = 1290-7 | month = Aug | year = 2007 | doi = 10.1043/1543-2165(2007)131[1290:IAOCRC]2.0.CO;2 | PMID = 17683191 }}</ref>/+ve (cytoplasmic) .
**Chromophobe renal cell carcinoma = cell membrane +ve.
 
===Sign out===
<pre>
PORTION OF KIDNEY, RIGHT, PARTIAL NEPHRECTOMY:
- ONCOCYTOMA.
</pre>
 
====Micro====
The sections show a tumour with cells arranged in nests. The tumour cells have abundant
eosinophilic cytoplasm. The tumour cell nuclei are round and have round nucleoli. No
perinuclear halos are apparent. Binucleation is not apparent. No zonal necrosis is
identified. Focally, tumour nests are spaced reminiscent of an archipelago. Mitoses are not
apparent. The tumour is moderately circumscribed.
 
The thin rim of renal parenchyma has no apparent pathology on the H&E stained sections.


==Angiomyolipoma==
==Angiomyolipoma==
Michael
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