Pulmonary metastatic renal cell carcinoma (clear cell type) in bronchial washings 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. Vascular structures may be seen in cell blocks. Immunocytochemistry (PAX8, RCC marker positive; TTF-1, napsin A negative) helps confirm renal origin. Metastatic RCC to lung is common and may present as solitary nodule. Distinction from primary clear cell lung adenocarcinoma is important; clinical history of renal cancer is crucial.

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Zambia

• ivwananji siwale – 29 pts

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