A 64-Year-Old Man Comes to the Office Due to Several

A 64-year-old man comes to the office due to several episodes of intermittent hematuria over the past 2 months.  He has had no abdominal pain, burning on urination, or fever but has lost 4.5 kg (10 lb) since the onset of symptoms.  The patient has smoked a pack of cigarettes daily for 30 years.  Vital signs are within normal limits.  The abdomen is soft, nontender, and nondistended.  Ultrasound reveals a mass in the right kidney.  A subsequent abdominal CT scan confirms the presence of a large right renal mass with evidence of necrosis.  The patient undergoes a right total nephrectomy.  The specimen is shown below. This patient's lesion most likely originated from which of the following portions of the kidney?

A) Blood vessels
B) Collecting duct cells
C) Glomeruli
D) Proximal renal tubules
E) Renal pelvis lining

Correct Answer:

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