Pulmonary metastatic renal cell carcinoma (clear cell type) in sputum shows cells with abundant clear or granular cytoplasm, round nuclei with prominent nucleoli, arranged in nests or sheets. The cytoplasm is clear due to glycogen and lipid content. Cells may be cohesive or discohesive. Metastatic RCC to lung is common, but exfoliation into sputum is rare unless there is endobronchial involvement. Cytological distinction from primary lung adenocarcinoma with clear cells can be difficult; immunohistochemistry (PAX8, RCC marker positive; TTF-1 negative) helps. Clinical history of renal cancer is crucial.

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Zambia

• Naomi Miselo – 31 pts

• Visual Pathway Lesions
• Positive and Negative Symptoms
• Hallucinations and Delusions
• Antipsychotic Medications
• Emergency: Environmental Emergencies