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Pathology

Histology of Renal Cell Carcinoma

Clear Cell Type

Histopathology of Renal Cell Carcinoma – Clear Cell
Ashley Davidoff MD
Histopathology of Renal Cell Carcinoma – Clear Cell
Ashley Davidoff MD

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 Histopathology of Renal Cell Carcinoma – Clear Cell
Ashley Davidoff MD

Papillary Cell Type RCC

Papillary Cell Renal Cell Carcinoma (RCC)
64 year old male
IVP at 20 seconds shows a mass in the right lower pole and 20 minute film conforms the finding.CT shows a deforming mass and US shows mildly hypoechoic mass. Pathology reveals papillary cell RCC
Ashley Davidoff MD

Granular cell Type

Histopathology of Renal Cell Carcinoma – Granular Cell
Ashley Davidoff MD

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Histopathology of Renal Cell Carcinoma – Granular Cell
Ashley Davidoff MD
Clear Cell
Renal Cell Carcinoma with Suggestion of Extension Beyond the Renal Capsule
Ashley Davidoff MD
Cystic Renal Cell Carcinoma (RCC) with Clear Cell Histology
Cystic renal cell carcinoma with dystrophic calcification in the mid portion of the left kidney. Pathology reveals cystic renal cell carcinoma with clear cell histopathology
Ashley Davidoff MD

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 Pathology of Renal Cell Carcinoma
Ashley Davidoff MD
Pathology of Renal Cell Carcinoma
Ashley Davidoff MD
Pathology of Renal Cell Carcinoma
Extension beyond the renal capsule
Ashley Davidoff MD
Pathology of Renal Cell Carcinoma
Ashley Davidoff MD

On IVP

Prone IVP
showing a mass in the right lower pole extending into the renal pelvis
Ashley Davidoff MD

 

IVP and Angiography

Renal Cell Carcinoma originating in the Right Upper Pole
IVP and Angiogram
a IVP in the nephrographic phase shows an enhancing mass off the upper pole of the right kidney.
b ? IVP in the pyelographic phase shows an a deformity of the upper and outer part of the right kidney
c ? Nephrographic phase of the arteriogram confirms a hyper vascular mass
d Renal angiogram with epinephrine confirms arterial enhancement of the mass with constriction of the normal vessels and failure of the abnormal response
Ashley Davidoff MD

 

Slow Growth

Slow growth of RCC
CT’ scans show two CT scans performed 2 years apart showing no significant growth
The ultrasounds below show mildly hyperechoic character of RCC
# renal cell cardcinoma#time
Ashley Davidoff MD

 

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 CT scan Pre and Post Contrast of RCC – Renal Cell Carcinoma
Ashley Davidoff MD
76776c

Invasion of the Renal Vein

 

 

Large Renal Cell Carcinoma Extending beyond the Renal Capsule
On CT there is dystrophic calcification. On angiography there is hypervascularity, neovascularity, AV shunting. Excretory phase after angiography shows distorted calyces
Ashley Davidoff MD
Hypervascular renal Mass with Metastases to the Renal vein, IVC, Pancreas and contralateral Kidney
40437c Courtesy Ashley Davidoff MD code kidney renal artery fx hypervascular mass fx arteriovenous shunting fx neovascularity code IVC invasion “string and thread” sign fx filling defect code left kidney hypervascular mass code pancreas celiac axis pancreatic head fx hypervascular mass code dx primary RCC renal cell carcinoma complicated by metastases to the left kidney and pancreatic parenchyma imaging radiology angiogram venogram code neoplasm primary metastasis malignant tumor carcinoma cancer

Dystrophic CAlcification

Exophytic Renal cell Carcinoma (RCC) with Dystrophic Calcification
Ashley Davidoff MD
Exophytic Renal cell Carcinoma (RCC) with Dystrophic Calcification
Ashley Davidoff MD

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 Exophytic Renal cell Carcinoma (RCC) with Dystrophic Calcification
Ashley Davidoff MD
Exophytic Renal cell Carcinoma (RCC) with Dystrophic Calcification
Ashley Davidoff MD

Cystic by CT

Cystic Renal Cell Carcinoma (RCC) with Clear Cell Histology
Cystic renal cell carcinoma with dystrophic calcification in the mid portion of the left kidney. Pathology reveals cystic renal cell carcinoma with clear cell histopathology
Ashley Davidoff MD
Cystic RCC
Renal Cell Carcinoma within a Cyst
Ashley Davidoff MD
34824c.1k
Acquired Cystic Disease of Chronic Renal Failure and Renal Cell Carcinoma
CT scan
Ashley Davidoff MD

 

Echogenic Renal Cell Carcinoma

Renal Cell Carcinoma originating from the Upper Pole of the Right Kidney and Presenting as an Echogenic Mass
Differential consideration is an angiomyolipoma
Ashley Davidoff MD


Hypervascular renal cell Carcinoma on Doppler Ultrasound

#kidney renal mass large cystic mass 2cms solid mass with hypervascularity hypervascular mass suggestion of arteriovenous shunting AV shunting large feeding arteriole and large draining vein dx renal cell carcinoma USscan Davidoff MD 48107c01

This series of USscans (a,b) and CT scans (c,d) show a solid hypervascluar mass in the lower pole of the right kidney. The findings are characteristic of a renal cell carcinoma. Note the complex lesion in the left lower pole. A second RCC is included in the differential diagnosis. 39056c code GU kidney mass hypervascular RCC radiologists and detectives
Ashley Davidoff MD

 

Renal cell carcinoma metastatic to lung and subpleural region
32303c01 code lungs pulmonary pleura nodules neoplasm malignant metastases metastasis primary renal kidney RCC imaging plain film CXR CTscan USscan gross pathology
Ashley Davidoff MD

 

Invasion into the Right Renal Vein and IVC

Large Renal Cell Carcinoma (RCC) invading the renal vein and IVC
Ashley Davidoff MD

Invasion into IVC and Extending to the Right Atrium (RA)

RCC – Right Lower Pole
MRI (T1 and T2 ) show a large mass in the lower pole of the right kidney
Ashley Davidoff MD

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 RCC invasion into the IVC and Right Atrium (RA)
Large mass in the right kidney (T1 and T2 top row)extending into the IVC (middle row and bottom left) as well as the right atrium (RA – bottom right)
Ashley Davidoff MD
RCC invasion into the Right Renal Vein and IVC
Large hypervascular mass in the right kidney . On the venous phase the filling defects with suggestion of hypervasscularity noted in the right renal vein and proximal IVC
Ashley Davidoff MD
RCC invasion into the IVC and Right Atrium (RA)
Inferior vena cavagram shows a large tumor thrombus extending into the IVC and right atrium (RA)
Ashley Davidoff MD

 

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 RCC Invasion into the Renal Vein and IVC
Renal Cell Carcinoma of the right kidney shows extension of hypervascular tumor thrombus into the right renal vein and IVC
Ashley Davidoff mD

RCC Originating in the Duct of Bellini

Renal Cell Carcinoma originating in the Cells of the Duct of Bellini with secondary Hydronephrosis of the Upper Pole Calyces
Multiphase Contrast Enhanced MRI
Top left ? Pre gadolinium shows mass like lesion
Top right Poorly visualized mass seen in the early arterial phase
Bottom 2 images ? heterogeneously enhancing mass in the right upper pole
Ashley Davidoff MD

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 Renal Cell Carcinoma originating in the Cells of the Duct of Bellini with secondary Hydronephrosis of the Upper Pole Calyces
Multiphase T2 Fat Sat Images
Top right and left ? Hydronephrosis right upper pole calyceal system, and mass with T2 bright component
Bottom 2 images ? Perinephric fluid collection around the mass
Ashley Davidoff MD
RCC with Delayed Nephrogram due to Renal Vein Thrombosis
23 F
kidney
fx delayed nephrogram
dx renal cell carcinoma
dx probable renal vein thrombosis
imaging radiology CTscan C+

Metastases to the Lung

RCC metastasis to Lung
Single Large metastasis
Ashley Davidoff MD
#renal cell carcinoma
31478c

 

 

Metastases Brain

Hypervascular Metastases to the Brain from RCC
Arterial Phase (upper Images)
Delayed Phase (lower images)
brain fx mass fx hypervascular dx renal cell carcinoma dx metastasis imaging radiology CTscan C+
Ashley Davidoff MD
RCC Metastatic to Lung and Brain
Ashley Davidoff MD
#renal cell carcinoma
77282c

 

Links and References

Muglia  VF, et al  Renal cell carcinoma: histological classification and correlation with imaging findings Radiol Bras vol.48 no.3 São Paulo May/June 2015