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→Clinical Summary
== Clinical Summary ==
The mother of this three-year-old male noticed a large mass in his abdomen. There were no other complaints. Physical examination and x-rays--including an intravenous pyelogram (IVP)--showed a large right renal mass. At surgery, a 550-gram right kidney was removed. There was no lymph node involvement, no extrarenal mass, and no involvement of the other kidney. Lung and bone x-rays showed no metastases. However, microscopic study of the surgical specimen confirmed a diagnosis of Wilms tumor and showed infiltration by the tumor (Grade II neoplasm) which had been difficult to separate from the duodenum. The child was placed on chemotherapy. Four months after the surgery to remove the tumor, a nodule was found in the lungs. The chemotherapy was resumed but the patient died four weeks later due to complications of Gram-negative sepsis. == Autopsy Findings ==At autopsy there was a single tumor nodule in the lungs.
== Images ==
<gallery heights="250px" widths="250px">
File:IPLab13WT1.jpg|This is autopsy specimen if from a similar case of a child who died of Wilms tumor. This gross photograph of a shows the bladder (1) to which are attached a normal kidney (2) and a kidney with Wilms' tumor (3). A large mass extends from the superior pole of the affected kidney. The renal capsule can be seen extending around this tumor. File:IPLab13WT2.jpg|This is a closer view of the kidney with Wilms' tumor (arrows).
File:IPLab13WT3.jpg|This is a gross photograph of lung from this case demonstrating the metastatic tumor nodule (arrow).
File:IPLab13WT4.jpg|This lowest-power view shows the tumor itself; no tissue is present that can be readily identified as normal kidney. There does appear to be a capsule surrounding the tumor. Eosinophilic bands are seen surrounding basophilic islands of cells. These correspond to the two types of tissue in this tumor--the basophilic cellular component termed "blastema" can be distinguished from less cellular eosinophilic areas.
File:IPLab13WT10.jpg|This high-power photomicrograph shows the differences in cell morphology between the blastema (1) and the fibroblast type cells (2).
</gallery>
== Virtual Microscopy ==
<peir-vm>IPLab13WT</peir-vm>
== Study Questions ==
=== Images ===
* [http://peir.path.uab.edu{{SERVER}}/library/index.php?/tags/265-wilms_tumor PEIR Digital Library: Wilms Tumor Images]
* [http://library.med.utah.edu/WebPath/RENAHTML/RENALIDX.html#8 WebPath: Renal Neoplasms]
{{IPLab 13}}
[[Category: IPLab:Lab 13]]