Renal Medullary Carcinoma
Yimin Ge, MD
Key Facts
Terminology
Rapidly growing medullary tumor associated almost exclusively with sickle cell trait
Clinical Issues
Predominantly young black males
Very aggressive; mean survival: 4 months
Cytopathology
Single cells, small loose clusters, or tubular pattern
Uniformly high-grade cells with scant cytoplasm
Hyperchromatic nuclei with irregular contours and prominent central nucleoli
Occasional cytoplasmic granules or vacuoles
Ancillary Tests
Positive for AE1/AE3 and CEA
Top Differential Diagnoses
Wilms tumor, yolk sac tumor, other high-grade malignancies
 (A) Pap-stained fine-needle aspiration of renal medullary carcinoma shows a loosely cohesive group of high-grade tumor cells, stromal fragments
 , and inflammatory cells  . (B) Medium magnification demonstrates high nuclear:cytoplasmic ratio, round to oval nuclei, and prominent central nucleoli  . Pap stain shows gland-like structures  and background neutrophils  . (C) High magnification of Pap stain reveals clear cytoplasm  with occasional cytoplasmic vacuoles  . (D) The nuclei are moderately pleomorphic with irregular contours and focal spindle morphology  on Pap stain. Stay updated, free articles. Join our Telegram channel
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