Systemic pathology: chromophobe renal cell carcinoma: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Systemic pathology: chromophobe renal cell carcinoma

Sample item

A 55-year-old man has a tan-brown renal mass. Histology shows large polygonal cells with prominent cell membranes, perinuclear clearing and wrinkled raisinoid nuclei. Colloidal iron staining is positive and CK7 is diffusely positive. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Chromophobe renal cell carcinoma

Chromophobe carcinoma arises from intercalated cells, with plant-like cell borders, perinuclear halos and raisinoid nuclei, and typically diffuse CK7 and colloidal iron positivity. It has a better prognosis than clear cell carcinoma. Oncocytoma is CK7 negative or focally positive and has uniform round nuclei.

Option by option

  • A. Chromophobe renal cell carcinoma (correct)

    Correct. Perinuclear halos, raisinoid nuclei and diffuse CK7 indicate chromophobe carcinoma.

  • B. Papillary renal cell carcinoma

    Papillary carcinoma shows papillae with foamy macrophages and psammoma bodies.

  • C. Clear cell renal cell carcinoma

    Clear cell carcinoma has lipid- and glycogen-rich clear cells with a delicate vascular network and VHL loss.

  • D. Renal oncocytoma

    Oncocytoma has uniform round nuclei, a central scar and little or focal CK7 positivity.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, Chromophobe renal cell carcinoma. Chromophobe carcinoma arises from intercalated cells, with plant-like cell borders, perinuclear halos and raisinoid nuclei, and typically diffuse CK7 and colloidal iron positivity.

Why is "Papillary renal cell carcinoma" not the answer?

Papillary carcinoma shows papillae with foamy macrophages and psammoma bodies.

Why is "Clear cell renal cell carcinoma" not the answer?

Clear cell carcinoma has lipid- and glycogen-rich clear cells with a delicate vascular network and VHL loss.

Why is "Renal oncocytoma" not the answer?

Oncocytoma has uniform round nuclei, a central scar and little or focal CK7 positivity.

What concept does this question test?

It tests Systemic pathology: chromophobe renal cell carcinoma in Pathology. It has a better prognosis than clear cell carcinoma. Oncocytoma is CK7 negative or focally positive and has uniform round nuclei.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Systemic pathology: chromophobe renal cell carcinoma?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.