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Clinical history
57-year-old with an incidental 45 mm renal mass on imaging.
Specimen
Partial nephrectomy · Stain: H&E
Microscopic description
Nests of cells with clear cytoplasma and distinct cell membranes separated by a delicate vascular network. Nucleoli visible at high power but not at low power.
Diagnostic question
How is nucleolar grading applied and what staging parameters must be reported?
Reveal differential diagnosis
Chromophobe renal cell carcinoma
Clear cell papillary renal cell tumour
Adrenal cortical neoplasm
Reveal final diagnosis
Clear cell renal cell carcinoma, WHO/ISUP grade 2
Learning points
WHO/ISUP grade is based on nucleolar prominence
Assess sinus fat, perinephric fat and vascular invasion
Report margin status for partial nephrectomy
Self-assessment
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All whole-slide images in this library are anonymised and used under appropriate licence. Cases are provided for education only and must not be used for clinical diagnosis.