Treating renal cell carcinoma in young adults: challenges and solutions

Figures & data

Table 1 Cytological features of key adolescent and young adult renal malignancies

Wilms’ tumor (triphasic)	Translocation renal cell carcinoma	Renal medullary carcinoma	Primitive neuroectodermal tumor/Ewing sarcoma	Collecting duct carcinoma
1. Blastemal: loose sheets of small round cells	Polygonal, eosinophilic, or clear	Mucinous tumor cells with hyperchromatic nuclei and prominent nucleoli	Monotonous round cells similar to wilms’ tumor	Poorly circumscribed, tubulopapillary tumor
2. Epithelial: tightly cohesive cells forming small cords	Psammoma bodies	Angiolymphatic invasion, desmoplastic stroma, infiltrative borders, and intratumoral neutrophils are common. Lymphocytes at rim	Apoptotic cells and necrosis are easily identified	Irregular channels lined by high- grade hobnail cells with marked desmoplastic response, brisk neutrophilic infiltrate, mucin production
3. Mesenchymal component binds them	May have intranuclear and/or intracytoplasmic inclusions	Hemorrhagic and geographic necrosis, frequent mitotic figures	Clusters	May have microcystic change ± an atypical hyperplastic component