Renal cell carcinoma pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Pathophysiology

Genetics

Recent genetic studies have altered the approaches of understanding renal cell carcinoma. [1][2][3]

Gross Pathology

Gross examination shows a hypervascular lesion in the renal cortex, which is frequently multilobulated, yellow (because of the lipid accumulation) and calcified.

Renal cell carcinoma: This 8-centimeter carcinoma of the lower pole of the kidney shows extension beyond the cortical surface, but it does not infiltrate the perinephric adipose tissue. Microscopically, it is of the clear cell type.

Light Microscopy

Light microscopy shows tumor cells forming cords, papillae, tubules or nests, and are atypical, polygonal and large. Because these cells accumulate glycogen and lipids, their cytoplasm appear "clear", lipid-laden, the nuclei remain in the middle of the cells, and the cellular membrane is evident. Some cells may be smaller, with eosinophilic cytoplasm, resembling normal tubular cells. The stroma is reduced, but well vascularized. The tumor grows in large front, compressing the surrounding parenchyma, producing a pseudocapsule.[4]

Secretion of vasoactive substances (e.g. renin) may cause arterial hypertension, and release of erythropoietin may cause polycythemia (increased production of red blood cells).

References

  1. Reuter VE, Presti JC (2000). "Contemporary approach to the classification of renal epithelial tumors". Semin. Oncol. 27 (2): 124–37. PMID 10768592. Unknown parameter |month= ignored (help)
  2. Bodmer D, van den Hurk W, van Groningen JJ; et al. (2002). "Understanding familial and non-familial renal cell cancer". Hum. Mol. Genet. 11 (20): 2489–98. PMID 12351585. Unknown parameter |month= ignored (help)
  3. Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease. St. Louis, Mo: Elsevier Saunders. p. 1016. ISBN 0-7216-0187-1.
  4. http://www.pathologyatlas.ro/Renal%20Clear%20Cell%20Carcinoma.html