A Renal Mass in a 66 Year Old Woman
Vickie Jo, MD
Presentation Date: August 1, 2016; Expires August 31, 2019
To understand the cytomorphologic features of this entity.
To gain competence in the role of immunohistochemistry in the diagnosis of renal neoplasms and its mimics.
To gain further understanding of the genetic features of this entity.
A 66 year old woman was found to have an enhancing 2.9 cm mass located in the right upper pole on CT scan performed for the evaluation of colitis. A 0.7 cm enhancing mass was also seen in the left kidney; overall the findings were suspicious for bilateral renal cell carcinoma, but subsequent imaging studies to further characterize the processes were initially technically unsuccessful. MRI at 9-months demonstrated the right renal mass to be heterogeneous and solid in nature, with size increase to 3.3 cm; the left subcentimeter mass was unchanged. A CT-guided fine needle aspiration biopsy was performed of the right kidney mass and demonstrated a cellular neoplasm. Immunohistochemical studies performed on cell block sections demonstrated positivity for AE1/AE3 (focal), WT-1, and BRAFV600E; EMA, CK7, CD34, desmin, and CD99 were negative. Representative images of the cytologic preparations, cell block, and selected immunostains are shown below.