case_images: PMC10939180_01
case_images: A - Gross pathologic examination of the cut surface with areas of hemorrhage and necrosis (sacle bar= 5 cm); B, C and D - photomicrographs of the tumor; B - displays spindle cell change with elongated tubules reminiscent of MTSCC (H&E, 100X); C - displays shaggy luminal surface (H&E, 400X); D - displays Alcian blue positive mucinous stroma (Alcian blue, 100X).
case_images: autopsy-14-e2024479-g01.jpg
case_images: PMC10939180_01_autopsy-14-e2024479-g01.jpg
case_images: gf01
case_images: Grossly, the mass was tan and well-circumscribed with hemorrhagic and necrotic foci (Figure 1A). PRCC (Figure 1C). Patchy prominent extracellular Alcian blue positive mucin deposits were also present (Figure 1D).
case_images: Photomicrographs of the tumor. A - displays an AMACR positive stain (100X); B - displays a CD10 positive stain, favoring PRCC (immunohistochemistry, low power, 100X); C - displays solid spindle cells in a whorled pattern (H&E, 100X); D - displays prominent nucleoli in whorled foci (H&E, 400X).
case_images: autopsy-14-e2024479-g02.jpg
case_images: PMC10939180_01_autopsy-14-e2024479-g02.jpg
case_images: gf02
case_images: PRCC and MTSCC express CK7, AMACR (Figure 2A), and EMA. However, the absence of expression of E-cadherin and strong CD10 expression favored PRCC (Figure 2B). Multiple foci of solid spindle cells in a whorled pattern with clear cell change, necrosis, and high-grade nuclei bordering on sarcomatoid RCC were present in other blocks (Figure 2C). A spectrum of spindle cell change was present, ranging from elongated tubules reminiscent of MTSCC to whorled foci with high-grade nuclei approaching sarcomatoid RCC (Figure 2D).