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Pathology

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Wilms’ Tumor

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Abstract

Wilms’ tumor (WT) is the most prevalent renal tumor of childhood. It is a malignant embryonal neoplasm taking its origin from embryonic renal precursor cells and showing divergent differentiation. WT can present monofocal or multifocal lesion(s), in unilateral or bilateral kidneys. The characteristic histological appearance is that of a triphasic tumor, comprising of blastemal, epithelial, and mesenchymal components. Not uncommonly, biphasic or monophasic tumors can also be seen, which may cause diagnostic dilemma. Anaplastic features can be identified in any of the three components and are important predictors for chemotherapy (ChT) resistance and poor prognosis. Neoadjuvant ChT is a common treatment modality for WT; hence, post-ChT specimens are thoroughly examined and evaluated to assess the response to therapy and presence of residual tumor.

Learning objectives of this chapter include the knowledge of the histomorphologic spectrum of WT, its morphologic mimics, and how to differentiate them. Handling of resection specimens and evaluation of post-ChT specimens for staging and risk stratification are also discussed.

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  1. Department of Pathology, Maulana Azad Medical College, New Delhi, India

    Parul Tanwar

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  1. Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children’s Hospital, New Delhi, India

    Yogesh Kumar Sarin

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Tanwar, P. (2022). Pathology. In: Sarin, Y.K. (eds) Wilms’ Tumor. Springer, Singapore. https://doi.org/10.1007/978-981-19-3428-5_7

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