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DOI: 10.1148/rg.266065010
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Common and Uncommon Histologic Subtypes of Renal Cell Carcinoma: Imaging Spectrum with Pathologic Correlation1

Srinivasa R. Prasad, MD, Peter A. Humphrey, MD, PhD, Jay R. Catena, MD, Vamsi R. Narra, MD, John R. Srigley, MD, Arthur D. Cortez, MD, Neal C. Dalrymple, MD and Kedar N. Chintapalli, MD

1 From the Department of Radiology, University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78229 (S.R.P., J.R.C., A.D.C., N.C.D., K.N.C.); the Department of Pathology, Washington University, St Louis, Mo (P.A.H.); the Department of Radiology, Mallinckrodt Institute of Radiology, St Louis, Mo (V.R.N.); and the Department of Pathology and Molecular Medicine, McMaster University, Mississauga, Ontario, Canada (J.R.S.). Recipient of a Magna Cum Laude award for an education exhibit at the 2004 RSNA Annual Meeting. Received January 24, 2006; revision requested February 24 and received March 30; accepted March 31. All authors have no financial relationships to disclose.

Figure 1
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  		Figure 1.  Gross specimen of a clear cell RCC shows variegated nodular growth (arrows) with areas of hemorrhage and necrosis (arrowheads).

 

Figure 2
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  		Figure 2.  Photomicrograph (original magnification, x200; hematoxylin-eosin [H-E] stain) of a clear cell RCC shows clear cells (black arrow) with prominent cell borders and prominent vasculature (blue arrow).

 

Figure 3
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  		Figure 3.  Contrast-enhanced CT scan of a clear cell RCC shows an expansile, heterogeneously enhancing right renal mass (arrows) with associated hypervascular retroperitoneal lymphadenopathy (arrowheads).

 

Figure 4
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  		Figure 4.  Axial gadolinium-enhanced T1-weighted MR image obtained during the corticomedullary phase shows a small, homogeneously enhancing, hypervascular clear cell RCC (arrows).

 

Figure 5
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  		Figure 5.  Contrast-enhanced CT scan obtained during the corticomedullary phase shows a predominantly cystic clear cell RCC (arrows) with peripheral solid, enhancing components (arrowheads).

 

Figure 6
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  		Figure 6.  Gross specimen of a multilocular cystic RCC shows a multiseptated cystic neoplasm (arrows).

 

Figure 7
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  		Figure 7.  Photomicrograph (original magnification, x100; H-E stain) of a multilocular cystic RCC shows neoplastic cells (arrows) lining macroscopic cysts.

 

Figure 8
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  		Figure 8.  Contrast-enhanced CT scan of a multilocular cystic RCC shows a large, expansile cystic mass (arrows).

 

Figure 9
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  		Figure 9.  Gross specimen of a papillary RCC shows a solid white mass (arrows). Scale is in centimeters.

 

Figure 10
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  		Figure 10.  Photomicrograph (original magnification, x100; H-E stain) of a type 1 papillary RCC shows a monolayer of small cytologically bland basophils growing along papillary fibrovascular cores (arrows).

 

Figure 11
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  		Figure 11.  Contrast-enhanced CT scan of a papillary RCC shows a small hypovascular mass (arrow) with discrete foci of calcification (arrowhead).

 

Figure 12
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  		Figure 12.  Nonenhanced CT scan of a papillary RCC shows a complex cystic mass with hemorrhage (arrow) and associated retroperitoneal lymphadenopathy (arrowheads).

 

Figure 13
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  		Figure 13.  Axial T2-weighted MR image of a papillary RCC shows a round, uniformly hypointense tumor (arrows). Note the multiple bilateral renal cysts (arrowheads).

 

Figure 14
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  		Figure 14.  Gross specimen of a chromophobe RCC shows an expansile mass with a solid yellow-brown cut surface (arrows).

 

Figure 15
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  		Figure 15.  Photomicrograph (original magnification, x200; H-E stain) of a chromophobe RCC shows characteristic perinuclear halos (arrows).

 

Figure 16
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  		Figure 16.  Axial gadolinium-enhanced fat-saturated three-dimensional gradient-echo MR image of a chromophobe RCC shows a relatively hypovascular, expansile right renal mass with slightly heterogeneous enhancement (arrows).

 

Figure 17
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  		Figure 17.  Photomicrograph (original magnification, x200; H-E stain) shows a high-nuclear-grade collecting duct carcinoma (arrows) with a basophilic matrix.

 

Figure 18
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  		Figure 18.  Power Doppler sonogram of a collecting duct carcinoma shows a solid, hypovascular medullary neoplasm (arrows).

 

Figure 19
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  		Figure 19.  Contrast-enhanced CT scan of a collecting duct carcinoma shows a heterogeneously enhancing left renal mass (arrows) with prominent calcifications (arrowheads).

 

Figure 20
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  		Figure 20.  Photomicrograph (original magnification, x100; H-E stain) of a renal medullary carcinoma (arrows) shows sheets of high-grade cells with a prominent lymphocytic response.

 

Figure 21
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  		Figure 21.  Contrast-enhanced CT scan of a renal medullary carcinoma shows a heterogeneously enhancing right renal mass (black arrow) with associated cystic retroperitoneal lymphadenopathy (white arrows).

 

Figure 22
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  		Figure 22.  Photomicrograph (original magnification, x200; H-E stain) of an Xp translocation RCC shows a tubulopapillary histoarchitecture (arrows).

 

Figure 23
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  		Figure 23.  Photomicrograph (original magnification, x300; H-E stain) of a neuroblastoma-associated RCC shows variably sized nuclei and papillary architecture (arrows).

 




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