Abstract
Background : Based on a review of the literature, we discuss typical but per haps not well known cytological findings associated with papillary renal cell carcinoma in light of our own case.
Case : A 72-year-old man found in computed tomography during a macroscopic hematuria work up (CT) to have an enlarged left kidney provided a radical nephrectomy specimen demonstrating multinodular formations occupying the entire kidney. Histologically, the tumor’s papillotubular structure consisted of atypical cells with eosinophilic cytoplasm and large nuclei with prominent nucleoli. Based on histological findings and immunohistological activity for CD10 and alpha-methyl CoA racemase (AMCAR), the tumor was definitively diagnosed as type 2 papillary renal cell carcinoma. Preoperative voided urine contained a few small clusters of atypical cells with prominent nucleoli. Intraoperative urine from the left ureter and touch−cytology during intraoperative consultation contained papillary clusters and hobnail patterns of atypical cells with hemosiderin-laden macrophages. Tumor cells had granular cytoplasm and large nuclei with prominent nucleoli.
Conclusion : Based on a comparison of previous reports with owr own case, type 2 papillary renal cell carcinoma typically presents cytological findings of papillary clusters, hobnail patterns, atypical large cells with granular cytoplasm and prominent nucleoli, and hemosiderin-laden macrophages.
