CASE 216 (February 2024)

Clinical information

A 4-year-old boy presents with a right renal mass that replaces the kidney by 70%. With a diagnostic impression of Wilms tumor, preoperative chemotherapy was initiated. After 8 weeks of treatment there does not seem to be an adequate response and a nephrectomy is performed. There is no personal pathological history. There are no extrarenal lesions.

Look at the images.

Figure 1.

Figure 2. Closer image.

Figure 3. H&E, X100.

Figure 4. H&E, X200.

Figure 5. H&E, X400.

Figure 6. H&E, X400.

Figure 7. H&E, X400.

Figure 8. H&E, X400.

Figure 9. H&E, X400.

Figure 10. H&E, X400.

Figure 11. Immunohistochemistry for WT1 completely negative, X400.

Figure 12. Immunohistochemistry for Cyclin D1: diffuse nuclear positivity, X400.

Myogenin, CD99, CD45, S100, chromogranin, synaptophysin, cytokeratins: Negative. INI1: diffuse nuclear positivity.

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