Sandbox: DDx Kidney mass: Difference between revisions

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* 10-30 yo sickle cell trait patients
* 50-70 yo males
* May have gross hematuria, back/flank pain, weight loss, and fever
* Asymptomatic
* Incidental finding


* Palpable renal mass  
* Palpable flank mass
* Lymphadenopathy


* Centrally located infiltrative mass invading the renal sinus
* Peripheral caliectasis
* Smaller peripheral satellite nodules
* Heterogeneous enhancement on CT
* Heterogeneous echotexture on US


* Solid, reticular, or tubular growth pattern
* Papillary foamy macrophages
* Hyperchromatic nucleus with a prominent nucleoli
* Intracellular hemosiderin
* Invasion of vessels and lymphatics
* Size 7 cm
* Desmoplastic stroma, central intratumoral neutrophils  with a rim of lymphocytes
* Hemorrhagic, necrosis, and increased mitotic figures


* Multifocal, well-circumscribed, mass
* Papillary fibrovascular cores
* Cuboidal cells, lower grade nuclei with a longitudinal nuclear groove and  a finely granular cytoplasm.
* Hyaline globules present
* Distinct fibrous capsule
* Trisomy 7
* Trisomy 17




==Nonmalignant causes==
==Nonmalignant causes==
anaplastic sarcoma clear cell sarcoma mesoblastic nephroma metanephric stromal tumor nephroblastomatosis / nephrogenic rests neuroblastoma oncocytoid carcinoma after neuroblastoma ossifying
anaplastic sarcoma clear cell sarcoma mesoblastic nephroma metanephric stromal tumor nephroblastomatosis / nephrogenic rests neuroblastoma oncocytoid carcinoma after neuroblastoma ossifying

Revision as of 14:50, 9 November 2015

  • 50-70 yo males
  • Asymptomatic
  • Incidental finding
  • Palpable flank mass


  • Papillary foamy macrophages
  • Intracellular hemosiderin
  • Size 7 cm


  • Multifocal, well-circumscribed, mass
  • Papillary fibrovascular cores
  • Cuboidal cells, lower grade nuclei with a longitudinal nuclear groove and a finely granular cytoplasm.
  • Hyaline globules present
  • Distinct fibrous capsule
  • Trisomy 7
  • Trisomy 17


Nonmalignant causes

anaplastic sarcoma clear cell sarcoma mesoblastic nephroma metanephric stromal tumor nephroblastomatosis / nephrogenic rests neuroblastoma oncocytoid carcinoma after neuroblastoma ossifying