An Unusual Renal Epithelial Tumor in a 66 Year Old Man
Marina Vivero, MD
Presentation date: July 1, 2015; Expires: July 1, 2018
A 66 year-old male presented with hematuria and 3.1 cm right renal mass. Core needle biopsy of the renal mass demonstrated a plasma cell-rich interstitial nephritis, which was managed conservatively. A year following his initial presentation, the patient again presented with night sweats, chills, weight loss, and a left neck mass. A CT scan at that time demonstrated a 4.2 cm right renal mass, multi-station lymphadenopathy of the abdomen and pelvis, a 6 cm right lung upper lobe mass, and soft tissue masses in the left superior mediastinum, inferior left neck, and T11-T12 paraspinal region. Fine needle aspiration biopsy of the mediastinal mass demonstrated a poorly-differentiated carcinoma, positive for Pax8, Cam5.2, and AMACR, and negative for CK7. Cytology preparations of a fine needle aspiration of the right renal mass are shown below. The specimen was also sent for cytogenetic and immunohistochemical work-up.