Question

Renal mass, haematuria, flank pain:

• A. Clear cell
• B. Papillary
• C. Chromophobic
• D. Belini (Collecting duct / Bellini)

Hint:

Flank pain + haematuria + mass = RCC; then subtype from the slide — look for plant-cell-like thick membranes, perinuclear haloes and raisinoid nuclei.

Answer 1

The Correct Option is C

Step 1: Read the clinical triad and images. The classic renal cell carcinoma (RCC) triad is flank pain, haematuria and a palpable abdominal/flank mass - all present here. The question shows a histology slide and a gross specimen of the renal tumour, and asks which RCC subtype is depicted.

Step 2: Distinguish the subtypes by morphology. RCC subtypes differ histologically: clear cell RCC has lipid-rich clear cytoplasm with a delicate vascular network; papillary RCC has papillae with foamy macrophages and psammoma bodies; chromophobe RCC shows large polygonal cells with prominent ("plant-like") cell membranes, perinuclear haloes and raisinoid wrinkled nuclei, and a solid sheet-like pattern; collecting-duct (Bellini) carcinoma is a rare, aggressive medullary tumour.

Step 3: Match to the per-key answer. Based on the morphology shown (cells with well-defined membranes, perinuclear clearing and raisinoid nuclei consistent with the chromophobe pattern), the intended answer is chromophobe RCC - Option C, in line with the printed key (Ans. C).

Step 4: Why the other options are not selected. (A) Clear cell RCC is the most common type overall but shows clear (not granular, membrane-accentuated) cytoplasm - not the pattern keyed here. (B) Papillary RCC has fibrovascular papillae with foamy macrophages, absent in this case. (D) Bellini/collecting-duct carcinoma is a rare high-grade medullary tumour and is not the morphology shown.

Final Answer: Option C - Chromophobe RCC.