Systemic pathology: renal oncocytoma: 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: renal oncocytoma

Sample item

A 60-year-old man has an incidental 5 cm well-circumscribed mahogany-brown renal mass with a central stellate scar. Histology shows nests of round cells with intensely eosinophilic granular cytoplasm, uniform round nuclei, and no necrosis or mitoses. What is the diagnosis?

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

The answer and the reasoning

B. Renal oncocytoma

Renal oncocytoma is a benign tumour of intercalated cells with mitochondria-packed eosinophilic cytoplasm, a mahogany-brown cut surface and central scar. Clear cell carcinoma is golden-yellow with haemorrhage and necrosis. Angiomyolipoma contains fat, vessels and smooth muscle.

Option by option

  • A. Angiomyolipoma

    Angiomyolipoma contains mature fat, thick-walled vessels and HMB-45 positive smooth muscle.

  • B. Renal oncocytoma (correct)

    Correct. Mahogany colour, central scar and granular eosinophilic cells indicate oncocytoma.

  • C. Clear cell renal cell carcinoma

    Clear cell carcinoma is a yellow tumour with clear cells, haemorrhage and necrosis.

  • D. Wilms tumour

    Wilms tumour is a triphasic embryonal tumour of young children.

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 B, Renal oncocytoma. Renal oncocytoma is a benign tumour of intercalated cells with mitochondria-packed eosinophilic cytoplasm, a mahogany-brown cut surface and central scar.

Why is "Angiomyolipoma" not the answer?

Angiomyolipoma contains mature fat, thick-walled vessels and HMB-45 positive smooth muscle.

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

Clear cell carcinoma is a yellow tumour with clear cells, haemorrhage and necrosis.

Why is "Wilms tumour" not the answer?

Wilms tumour is a triphasic embryonal tumour of young children.

What concept does this question test?

It tests Systemic pathology: renal oncocytoma in Pathology. Clear cell carcinoma is golden-yellow with haemorrhage and necrosis. Angiomyolipoma contains fat, vessels and smooth muscle.

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: renal oncocytoma?

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.