General and Systemic Histopathology, C601&C602
    Slide 80: Lung with metastatic renal cell carcinoma, spindle cell pattern
    The appearance of this malignancy is a little atypical.  Generally the metastases pretty faithfully reproduce the histological pattern of the primary lesion.  Renal cell is probably the one tumor that most consistently breaks this rule.  Here we see two patterns in the same metastatic focus; a spindle pattern and the more typical clear cell pattern.

    See this slide with the virtual microscope.

    This slide shows the "spindle cell" variant of this malignancy. It is actually not the typical appearance, but the next slide does show the more characteristic so-called clear cell pattern. This slide shows lung tissue essentially replaced with metastatic renal cell carcinoma. Notice how in this area the malignant cells have an elongate or spindle appearance. Some cancers, especially renal cell carcinoma, can show a multifaceted histological pattern. It would be very difficult to make an accurate diagnosis as to the origin of this tumor if this were the only piece of tissue given the pathologist.

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