Cytologically Yours: CoW: 20131209

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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.


  • 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.




Resident Questions

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Final Diagnosis


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