PathMD Quizes, Renal Renal Neoplasms – 02 October 29, 2017 peferguson Make sure to subscribe to PathMD to stay up to date with new content and features!! 1. A 30 y/o African American male whose mother has sickle cell disease, is found to have a renal mass by CT examination. Which of the following are the most likely histologic features of this mass:Tubulopapillary architecture of infiltrating cells some with a hobnail like appearance. Tumor cell nuclei are high grade. Reticular / yolk sac-like pattern with focal areas having an adenoid-cystic pattern. Papillary cores filled with foamy macrophages admixed with other areas of tubular and solid architecture. The cytoplasm is acidophilic, and no clear cell component is identified. Clear cells with abundant cytoplasm, irregular nuclei, and a fine network of thin walled vessels surrounding nests of cells. Tubular Mucinous Spindle cell RCC 2. A renal tumor has predominantly clear cells with the highest grade area containing cells with irregular nuclear border (size ~20m) and nucleoli visible from 10X. Many of the cells are noted to have eccentrically placed nuclei and eosinophilic cytoplasm. The best Fuhrman grade is:Fuhrman grade IFuhrman grade IIFuhrman grade IVFuhrman grade VFuhrman grade III 3. The best diagnosis for the renal mass illustrated in the images below is which of the following: Renal Tumor Renal Tumor Renal TumorRenal Cell Carcinoma, Chromophobe None of the above Renal Cell Carcinoma, Papillary Renal Cell Carcinoma, Conventional Oncocytoma 4. Which of the following result in the highest stage for a renal cell carcinoma according to the 2002 AJCC staging manual:Tumor grossly extends into the vena cava above the diaphragmTumor directly invades adrenal gland Tumor invades beyond Gerota’s fasciaTumor grossly invades the wall of the vena cava Metastasis to one single regional lymph node 5. The best diagnosis for the renal mass illustrated in the images below is which of the following: Renal Tumor Renal Tumor Renal TumorRenal Cell Carcinoma, Conventional Renal Cell Carcinoma, ChromophobeOncocytomaNone of the aboveRenal Cell Carcinoma, Papillary 6. The best diagnosis for the renal mass illustrated in the images below is which of the following: Renal Tumor Renal Tumor Renal TumorRenal Cell Carcinoma, ChromophobeRenal Cell Carcinoma, Conventional OncocytomaRenal Cell Carcinoma, PapillaryNone of the above 7. This tumor from the kidney illustrated in images below was negative for S-100 and desmin. In other areas of the tumor, RCC marker was focally positive. Which of the following is the best diagnosis? Renal Tumor Renal TumorMetastatic malignant melanoma None of the above RCC, Fuhrman grade IV RhabdomyosarcomaLeiomyoma 8. Which of the following is most helpful in differentiating chromophobe RCC from an oncocytoma:Perinuclear halosBinucleationPleomorphismGranular cytoplasm 9. An 18 y/o Caucasian male is found to have a renal tumor with clear cell RCC histology. It is important to perform cytogenetic analysis on this mass to look for involvement of which of the following chromosomes:Chromosome 11p13 Xp11.23pChromosome 7None of the above 10. A 5 cm mass is removed from a 41 y/o female which is found to have areas of smooth muscle cells, blood vessels, and fat. Special stains for HMB-45 were positive. This lesion is associated with all of the following conditions EXCEPT:von Recklinghausen disease von Hippel-Lindau (VHL) syndrome Birt-Hogg-Dube syndrome Tuberous sclerosis 11. According to the AJCC staging manual, all of the following affect the pathological staging of renal cell carcinoma EXCEPT:Fuhrman grade Renal vein involvement Extension into renal sinus fat Extension into perinephric fat Size 12. The image below shows a renal tumor stained with Hale’s Colloidal Iron. The most likely diagnosis is: Renal Tumor Hale's Colloidal IronRCC, sarcomatoid type RCC, conventional type RCC, papillary type OncocytomaRCC, chromophobe type 13. The best diagnosis for the renal mass illustrated in the images below is which of the following: Renal Tumor Renal Tumor Renal Tumor Renal TumorNone of the above Renal cell carcinoma, papillary typeMetanephric adenoma RhabdomyosarcomaWilm’s tumor 14. An incidental renal lesion <1cm with papillary features and composed of predominantly clear cells is best classified as:Renal cell carcinoma, chromophil typeRenal cell carcinoma, clear cell type Papillary adenoma Papillary carcinomaRenal cell carcinoma, NOS Loading...