A 65-year-old man comes to the office for evaluation of blood in the urine. The patient has no abdominal pain, urinary frequency, or urgency. He has hypertension, type 2 diabetes mellitus, and stage II chronic kidney disease. He quit smoking 10 years ago and had smoked a pack of cigarettes daily for 30 years. On examination, vital signs are within normal limits. The patient's BMI is 33 kg/m². After appropriate work-up, the patient undergoes a renal biopsy; histopathologic findings are shown below. Which of the following processes most likely accounts for the abnormal appearance of these cells?

Question

Quizplus · Accepted Answer

Eductional Objective: The most common renal malignancy is clear cell carcinoma, which arises from renal proximal tubular cells.  Rounded or polygonal cells with abundant clear cytoplasm are seen on light microscopy.  The cells contain large amounts of glycogen and lipids that dissolve during routine tissue preparation, leaving clear spaces within the cytoplasm.

A 65-Year-Old Man Comes to the Office for Evaluation of Blood