"Indeterminate" cystic lesion of the kidney partially lined by small cells with clear cytoplasm--malignant or benign?
Complex renal cysts, which present radiographically as "indeterminate for malignancy" (Bosniak category III), can prove challenging both pathologically and clinically. We report a case of a renal cyst that, by standard radiographic and histologic criteria, should have been diagnosed as a malignant cystic renal cell carcinoma. However, the cytogenetic profile appeared more closely consistent with cystic renal adenoma or low-grade papillary renal cell carcinoma--tumors with limited metastatic potential. We postulate that other, similarly complex, renal cysts might also be more precisely defined by meticulous histopathologic examination, supported by cytogenetic study.
Fromowitz
Frank B
FB
Department of Pathology, University of Medicine and Dentistry New Jersey Medical School, Newark, New Jersey, USA.
Watson
Richard A
RA
Kansal
Neil S
NS
Barbashina
Violetta
V
Esposito
Michael
M
Irwin
Robert J
RJ
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics; D018288:Carcinoma, Small Cell / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics; D020732:Cytogenetic Analysis; D003593:Cytoplasm / Q000737:chemistry* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D052177:Kidney Diseases, Cystic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics; D008875:Middle Aged; D011859:Radiography