Kidney, Clear cell renal cell carcinoma

The conventional clear cell variant is the most common histologic subtype of renal cell carcinoma. Grossly, these tumours are often centered in the renal cortex and are well circumscribed lobulated masses. They often have a yellow appearance due to the rich lipid and glycogen content of the tumour cells. They can also show cystic change, as well as foci of hemorrhage and necrosis. Microscopically, they are classically composed of clear cells arranged in sheets or nests, separated by a delicate vascular network ("chicken wire vasculature"). Necrosis can be seen, as well as sarcomatoid or rhabdoid change.

This tumour was graded as a Furhman Grade 4 (grading system based on nuclear features). In this case, there was also direct extension into the adrenal gland, invasion of the renal vein, and tumour thrombus in the IVC.