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1:
Papillary Renal Cell Carcinoma
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Comments: Papillary renal cell carcinoma comprises 15% to 18% of renal cell carcinoma. Note the prominent papillary structures many of which enclose clusters of foamy macrophages.
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3:
Papillary Renal Cell Carcinoma
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Comments: The papillary architecture in this tumor is more delicate and lacks foamy histiocytes. When closely packed, it can create near-solid appearance.
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4:
Papillary Renal Cell Carcinoma
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Comments: This 38 y/o man presented with flank pain and hematuria. Imaging studies showed stone in the ureter with severe hydronephrosis. The patient underwent radical nephrectomy which revealed xanthogranulomatous pyelonephritis and multiple whitish lesion in the renal cortex and medulla ranging in size from 0.2 cm to 1.0 cm. This low-power scan of the slide reveals a 1.0 cm diameter papillary tumor arising in a cyst wall. Case contributed by: Diane Cavalcante, MD, Fortaleza, Ceara, BRAZIL.
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5:
Papillary Renal Cell Carcinoma
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Comments: The papillary fronds are clearly visible even at low magnification. The surrounding renal parenchyma is scarred and shows sclerotic glomeruli surrounded by chronic inflammation.
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6:
Papillary Renal Cell Carcinoma
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Comments: The tumor cells lining papillary fronds have moderate amounts of eosinophilic cytoplasm and uniform round or oval nuclei with little atypia. Such foci were considered to represent papillary renal cell carcinoma.
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7:
Papillary Renal Cell Carcinoma
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Comments: Numerous smaller lesions with papillary architecture were scattered throughout the kidney. They ranged in size from microscopic to a few mm. One such lesion is shown here in its entirety. Currently, no reliable histologic criteria exist to separate small renal cortical adenomas that lack the potential to progress from those that are capable of metastases. The use of tumor size as a criterion for this distinction is controversial and considered unreliable by many pathologists. Certainly any tumor with clear cells should be considered to be capable of progression regardless of size.
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