| A 20-month-old male with a past medical history significant for premature birth presented with an abdominal mass on incidental palpation by his mother. U/S showed a cystic mass of the right kidney. A nephrectomy was subsequently performed.
LABORATORY DATA
Noncontributory.
ANCILLARY STUDIES
CT scan and ultrasound demonstrated a cystic mass with multiple anechoic spaces.
GROSS PATHOLOGY
Figure 1 is a gross picture showing a discrete, well-demarcated mass formed by multiple, noncommunicating cysts filled with a small amount of clear serous fluid. The residual renal parenchyma is unremarkable.
MICROSCOPIC PATHOLOGY
Sections (Figure 2 and Figure 3) demonstrate a cystic mass composed of thin-walled, epithelial-lined spaces with intervening, loose fibromuscular stroma with some myxoid change. The epithelial cells lining the cystic spaces are predominately low cuboidal and occasionally bud into the luminal cavity ("hobnail cells"). The intervening stroma shows no blastema. Scattered mature tubules and immature glomeruli are present in some areas of stroma between the cystic areas. The remainder of the kidney is unremarkable.
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