A 34-year-old male underwent a left radical nephrectomy for a suspected left renal tumor. Upon gross examination, the left kidney weighed 620g and contained a solid tumor measuring 11x9x7.5cm with areas of necrosis and hemorrhage. Microscopic examination revealed the tumor to be a papillary renal cell carcinoma, Fuhrman grade I, with renal sinus invasion but no capsular invasion. The renal vessels, ureter, and a single hilar lymph node were free of tumor, as was the attached left adrenal gland and perirenal fat.

1. Tumor Board
18/07/2017

2. PATIENT DETAILS
• NAME: Palanivel
• AGE: 34 years/ Male
• HOSPITAL OP/ IP NO: 12/031744 / 16/019139
• BIOPSY NOS: 1220/16 & 1221/16
• DATE OF RECEIVING SPECIMEN: 07/06/2017
• CLINICAL DIAGNOSIS: Left renal tumor
• NATURE OF SPECIMEN: : Left radical nephrectomy

3. Gross Examination
• Received already cut open radical
left nephrectomy specimen
weighing 620 g, measuring
16 x 14.5 x 5.5cm.
• On cut section, the tumor was
seen on the upper pole
measuring 11 x 9 x 7.5cm.
• On cut section, the tumor
appeared solid with large areas of
necrosis and hemorrhage.
• No capsular breach was seen.
• The perirenal fat appeared free of
tumor grossly.
• The renal sinus appeared free of
tumor grossly.
• One hilar lymph node was
identified measuring 0.2x 0.2 x
0.2cm.

4. Gross Examination
• Received left adrenal
gland measuring
4.5x2.5x1.5cm, with
attached pad of fat.
• No tumor was identified
grossly.

5. Microscopical Examination

6. Microscopical Examination

7. Microscopical Examination

8. Microscopical Examination

9. Microscopical Examination

10. Microscopical Examination

11. Microscopical Examination
• Section from kidney shows a tumor composed
of cells arranged in papillary fashion with
fibrovascular core containing foamy
macrophages.
• The tumor shows areas of necrosis with
cholesterol crystals and a focus of calcification.
• The cells are small with scant cytoplasm and
bland looking nuclei with inconspicuous
nucleoli.

12. Microscopical Examination
• Section shows adrenal gland of normal
histology.
• No tumor invasion seen.

13. Impression
• Renal cell carcinoma- Papillary type I (Fuhrman nuclear
grade I).
• Renal sinus invasion seen.
• No capsular invasion seen.
• Renal vessels and ureter resected margins are free of
tumor.
• One hilar lymph node identified which is free of tumor.
• Attached adrenal and perirenal pad of fat is free of
tumor.