Question:medium
Renal mass, haematuria, flank pain:
Renal mass, haematuria, flank pain:
Show Hint
Flank pain + haematuria + mass = RCC; then subtype from the slide — look for plant-cell-like thick membranes, perinuclear haloes and raisinoid nuclei.
Updated On: Jun 22, 2026
- Clear cell
- Papillary
- Chromophobic
- Belini (Collecting duct / Bellini)
Show Solution
The Correct Option is C
Solution and Explanation
Pattern-recognition route.
The stem gives the textbook RCC triad - flank pain + haematuria + renal mass - so this is renal cell carcinoma; the task is purely to subtype it from the gross and microscopic pictures.
Build a quick morphology key:
• Clear cell → sheets of cells with $optically\ clear$ (lipid/glycogen) cytoplasm and a fine "chicken-wire" capillary network; commonest subtype.
• Papillary → finger-like papillae cored by fibrovascular stalks with foamy macrophages ± psammoma bodies.
• Chromophobe → large pale-to-eosinophilic polygonal cells with thick, sharply outlined plant-cell-like membranes, perinuclear haloes and wrinkled "raisinoid" nuclei; tan-brown well-circumscribed gross mass.
• Bellini (collecting duct) → rare, central/medullary, infiltrative, highly aggressive.
Apply the key.
The image features matching prominent cell membranes, perinuclear clearing and raisinoid nuclei correspond to the chromophobe entry, and this agrees with the official key (Ans. C). Hence $answer = Option\ C$.
Why not the others: no optically clear cytoplasm (rules out clear cell), no fibrovascular papillae/foam cells (rules out papillary), not a rare infiltrative medullary mass (rules out Bellini).
Conclusion: Chromophobe RCC.
The stem gives the textbook RCC triad - flank pain + haematuria + renal mass - so this is renal cell carcinoma; the task is purely to subtype it from the gross and microscopic pictures.
Build a quick morphology key:
• Clear cell → sheets of cells with $optically\ clear$ (lipid/glycogen) cytoplasm and a fine "chicken-wire" capillary network; commonest subtype.
• Papillary → finger-like papillae cored by fibrovascular stalks with foamy macrophages ± psammoma bodies.
• Chromophobe → large pale-to-eosinophilic polygonal cells with thick, sharply outlined plant-cell-like membranes, perinuclear haloes and wrinkled "raisinoid" nuclei; tan-brown well-circumscribed gross mass.
• Bellini (collecting duct) → rare, central/medullary, infiltrative, highly aggressive.
Apply the key.
The image features matching prominent cell membranes, perinuclear clearing and raisinoid nuclei correspond to the chromophobe entry, and this agrees with the official key (Ans. C). Hence $answer = Option\ C$.
Why not the others: no optically clear cytoplasm (rules out clear cell), no fibrovascular papillae/foam cells (rules out papillary), not a rare infiltrative medullary mass (rules out Bellini).
Conclusion: Chromophobe RCC.
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