Paediatric pathologyIntermediateAnnotated

Wilms tumour (nephroblastoma)

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Clinical history

3-year-old with an abdominal mass.

Specimen

Radical nephrectomy · Stain: H&E

Microscopic description

Triphasic tumour with blastemal, epithelial and stromal components. No nuclear anaplasia identified in sections examined.

Diagnostic question

Why is anaplasia assessment critical in this tumour?

Reveal differential diagnosis
  • Clear cell sarcoma of kidney
  • Rhabdoid tumour
  • Congenital mesoblastic nephroma
Reveal final diagnosis

Nephroblastoma, triphasic, no anaplasia identified

Learning points

  • Anaplasia determines risk stratification
  • Assess capsular and sinus invasion
  • Note prior chemotherapy effect where applicable

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