Sandbox: DDx Kidney mass: Difference between revisions

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* 50-60 yo patients
* May have refractory hypertension, palpitations, headache, diaphoresis, anxiety,  weight loss, and flank pain
* Flank pain and hematuria
* MEN, von Hippel–Lindau disease, tuberous sclerosis, or neurofibromatosis
* Birt-Hogg-Dubé syndrome


* Palpable flank mass
* Pallor
* Tachycardia


* Pale cytoplasm
* Elevated serum catecholamines and metanephrines
* Streaks of eosinophilic material
* "Cobwebs" appearance
* Perinuclear clearing
* Psammoma bodies


* Multiple losses of entire chromosomes 1, 2, 6, 10, 13, 17, 21 and Y
* Large, heterogeneous mass  on CT
* Areas of necrosis and cystic change
*  on CT
 
* VHL, RET, NF1SDHB and SDHD gene mutation


==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 16:51, 9 November 2015

  • May have refractory hypertension, palpitations, headache, diaphoresis, anxiety, weight loss, and flank pain
  • MEN, von Hippel–Lindau disease, tuberous sclerosis, or neurofibromatosis
  • Pallor
  • Tachycardia
  • Elevated serum catecholamines and metanephrines
  • Large, heterogeneous mass on CT
  • Areas of necrosis and cystic change
  • on CT
  • VHL, RET, NF1SDHB and SDHD gene mutation

Nonmalignant causes

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