Female 48 years

Right radical nephrectomy for tumour (Clear cell renal cell carcinoma, WHO/ISUP G2, pT3a). Additional abnormality in medulla.



Specimen: Right kidney.

Macro: Kidney 125x77x62mm with perinephric fat. There is a pale brown, well circumscribed tumour 38mm in maximum diameter. The submitted slide is from the macroscopically uninvolved renal medulla.

Immunohistochemistry:
None.

Female 43 years

Right distal ureterectomy for stricture. Previous Bilharzia.



Specimen: Distal ureterectomy.

Macro: The pot contains two segments of ureter, both of which have a clip at one end (there is no description of orientation on the form or container). The larger piece measures 28mm in length by up to 15mm in width. The second piece measures 8mm in length x 11mm in width. For the larger piece, the clipped end is inked green, the opposite end is inked blue and the mid portion is inked yellow. For the smaller piece, the clipped end is inked green and the opposite end is inked blue (the opposite end is more dilated). All embedded in A1-A5.

Immunohistochemistry:
None performed. ZN special staining is negative.

Male 27 years

Right testicular mass.



Specimen: Right testis.

Macro: A testis measuring 5 x 3 x 2.8 cm with spermatic cord measuring 2.8 cm in length. The testis contains a multinodular tumour. Tumour nodules are grey-white; the largest measures 2.1 x 2.9 x 2 cm.

Immunohistochemistry:
The tumour cells are positive for CD117, PLAP and OCT-3/4.

Female 68 years

Right lower lobe renal mass.



Specimen: Right laparoscopic radical nephrectomy **SUPPLEMENTARY QUESTION**

Macro: The kidney measures 10.1 x 6.2 x 5.2 cm in size. On opening the specimen there is a well-circumscribed, solid and yellow tumour with focal gelatinous/ fleshy appearance present within the lower pole, 3.5 x 3.4 x 3 cm in size. The tumour abuts both renal capsule and renal sinus without definite involvement grossly seen.

Immunohistochemistry:
None performed.

Female 68 years

First tumour resection.



Specimen: TURBT.

Macro: Multiple fragments together 15 x 15 x 3mm.

Immunohistochemistry:
Positive staining for: PAX8, CK7, CA125, AMACR, 34BE12 and weakly for Napsin A. CK20 stains isolated cells. p63, GATA3, ER and WT1 are negative.

Male 16 years

R testicular lesion ??Ca.



Specimen: Right orchidectomy.

Macro: Testis measures 38 x 30 x 18 mm. Tumour in lower pole. 10 x 10 x 8 mm. Tumour cells are positive for Inhibin, Calretinin, Vimentin, Steroidogenic factor-1 (SF-1) Occasional tumour cells show focal, delicate to dot positivity for CAM5.2 and AE1/3. Beta catenin shows membrane staining only.

Immunohistochemistry:
Tumour cells are negative for Chromogranin, EMA, MIC-2, SMA, S-100, LCA, c-kit, Melan A and HMB45. MIB1 stains <5% of tumour cell nuclei.

Female 38 years

Right upper pole renal cortex mass.



Specimen: Core biopsies.

Macro: 2 pale and haemorrhagic cores measuring 20mm and 18mm.

Immunohistochemistry:
Diffusely positive with CK7. The larger eosinophillic cells are positive with cyclin D1.

Male 76 years

Post BCG for bladder TCC. Check cystoscopy and biopsy.



Specimen: bladder biopsy.

Macro: 4 biopsies 4mm each.

Immunohistochemistry:
not performed.

Male 20 years

Presented with neck mass - metastatic germ cell tumour. Post chemo retroperitoneal node dissection.



Specimen: Paracaval nodes.

Macro: Nodular piece of tissue 52x34x26mm including a nodule 36x32x22mm which is solid and cystic with white-cream cut surface.

Immunohistochemistry:
None.

Female 65 years

Left renal tumour.



Specimen: Left nephrectomy.

Macro: The specimen comprises of kidney with perinephric fat and a segment of ureter. The kidney with perinephric fat measures 150 x 90 x 70mm. The kidney itself measures 110 x 65 x 60mm. The segment of ureter measures 35mm. Gerotas fascia is included. Adrenal gland is not included. Sectioning shows a lobulated, partly tan coloured tumour measuring 72mm in maximum dimension. The tumour is seen within the upper pole of the kidney and focally protrudes into renal sinus fat, but no direct invasion is seen. The tumour lies 2mm from the nearest perinephric fat resection margin. The tumour does not involve the renal vein or pelvi-calyceal system. Background kidney shows a simple cyst measuring 12mm.

Immunohistochemistry:
The tumour cells are immunopositive for CK 7 ( diffuse ), AMACR, RCC and CD10 ( focal ). The tumour cells are immunonegative for synaptophysin and CD56. Mucinous material is stained with Alcian blue.

Male 74 years

T2 Bladder cancer no chemo.



Specimen: Cystectomy **SUPPLEMENTARY QUESTION**

Macro: Cystoprostatectomy measuring 130 x 60 x 50mm. Within the left lateral wall of the bladder, just superior to the left ureter, is a firm pale tumour invading to a depth of approximately 15mm. It appears to extend to the outer muscularis propria, very close to the perivesical fat. The lesion appears at least 6mm clear of the closest resection margin.

Immunohistochemistry:
None.

Male 62 years

Mottled pearly lesion on the inner part of foreskin. Excisional biopsy.



Specimen: Foreskin.

Macro: Foreskin measuring 17 x 10 x 2mm with a nodular lesion measuring 10mm.

Immunohistochemistry:
IHC - Melan A.

Male 81 years

PSA 16.4. PIRADS 5 left anterior mid to apical. Suspected early encroachment into seminal vesicles.



Specimen: Prostate TEMPLATE Biopsy - left anterior.

Macro: 2 needle cores of tissue.

Immunohistochemistry:
None.

Male 54 years

Prostate biopsies (R + L = 5 cores + 5 cores). PSA 0.7, 15.9ug/L (sudden rise). MRI PIRADS 5 R +L PZ ?capsular breach right side.



Specimen: Prostate biopsy right lobe.

Macro: 5 cores measuring 1.0 to 1.5cm.

Immunohistochemistry:
2 stains: AMACR & HMCK (provided).

Male 80 years

Right prostate cores.



Specimen: Prostate core biopsy.

Macro: Right mid posterior cores.

Immunohistochemistry:
None provided.