The kidney is primarily composed of glomeruli, tubules, stroma, and vasculature. However, unlike in some other organs, the neoplasms of the kidney do not faithfully reflect or recapitulate their cells of origin. Therefore, recognizing a lesion is not so much a systematic process as a pattern recognition. However, there are certain features to notice in evaluating any kidney mass, as they will help narrow the differential diagnosis in tough cases:

  1. 1.

    Circumscription and/or encapsulation

  2. 2.

    Presence of stroma within the tumor

  3. 3.

    Vascular or capillary pattern

  4. 4.

    Architectural pattern (solid, acinar, trabecular, tubular, papillary, pseudopapillary, cystic)

  5. 5.

    Cellular pleomorphism (monotonous to bizarre)

  6. 6.

    Mitotic activity

  7. 7.

    Cytoplasm (clear to granular pink to densely eosinophilic; perinuclear halos)

  8. 8.

    Nuclear size and contour (note the shape and whether the membrane is smooth or wrinkled)

  9. 9.




Renal Cell Carcinoma Clear Cell Papillary Renal Cell Carcinoma Clear Cell Sarcoma Papillary Adenoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer Science+Business Media, LLC 2008

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