Cytologically Yours: CoW: 20131209

Clinical Summary

The patient is an 64 year old white male who presented with left sided back pain. Imaging showed a left perinephric retroperitoneal hematoma and a left renal lower pole cystic lesion with hemorrhage. Additional imaging showed numerous pulmonary lesions. An endobronchial ultrasound guided fine needle aspiration was scheduled.

Past Medical History

  • Congestive heart failure
  • Ventricular tachycardia
  • Ischemic heart disease

Past Surgical History

  • Coronary stent placement
  • Implant of AICD


Clinical Plan

The concern is a primary renal malignancy with metastatic disease to lungs. An endobronchial ultrasound guided FNA is scheduled. An onsite rapid diagnosis by cytology was scheduled.

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Radiology

  • CT Abdomen shows a large perinephric hematoma and large low anterior structure in left lower pole suspicious for a hemorrhagic renal cell carcinoma.
  • CT Chest shows multiple small lung lesions measuring up to 13x12 mm in greatest dimension.
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Pathology

Cytology

Immunohistochemistry

Resident Questions



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Final Diagnosis

Cytology

  • Rapid diagnosis: Non-small cell carcinoma.
  • Final diagnosis: Renal cell carcinoma.



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Last modified on 15 January 2014, at 17:01