case_images: PMC11688622_01
case_images: Gross examination of 3.2 cm renal tumor: Well-circumscribed multi-lobulated light yellow tan mass with no tumor necrosis or hemorrhage.
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case_images: dc25422-fig-0001
case_images: Sectioning of the resected 3.2 cm right lower pole renal mass revealed light yellow tan, encapsulated, well-circumscribed multilobated mass with no tumor necrosis or hemorrhage (Figure 1).
case_images: (A) Neoplastic cells in nested cohesive clusters or in single form. The spindle cells at edge of the nests (Diff-Quik stain, x200 magnification). (B) Neoplastic cells with nuclei showing mild polymorphism. Granular cytoplasm is easily stripped off. Rare spindled cells are present (Diff-Quik stain, x400 magnification). (C) Loosely cohesive cluster of neoplastic cells with nuclei showing even chromatin and indistinct nucleoli. Spindled cells can be appreciated (Papanicolaou stain, x400 magnification).
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case_images: dc25422-fig-0002
case_images: Diff-Quik stained direct smears showed neoplastic cells in nested cohesive clusters or in single form (Figure 2A). The neoplastic cells contained nuclei showing mild polymorphism and granular cytoplasm (Figure 2B). Spindled cells could be also appreciated (Figure 2C).
case_images: (A) Neoplastic cells in nests. Arterioles with concentric and hyalinized walls (hematoxylin and eosin stain, x100 magnification). (B) Glomoid appearance with sheets of polygonal to oval cells with eosinophilic granular cytoplasm. Hemangiopericytoma-like capillaries (hematoxylin and eosin stain, x200 magnification). (C) Neoplastic cells with distinct cellular borders, mild nuclear polymorphism with occasional intranuclear pseudo-inclusions, and abundant eosinophilic granular cytoplasm. Mitotic figures and tumor necrosis are not identified (hematoxylin and eosin stain, x400 magnification).
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case_images: dc25422-fig-0003
case_images: Arterioles with concentric and hyalinized walls suggestive of hypertensive effect were readily identified (Figure 3A). Prominent hemangiopericytoma-like capillaries were present (Figure 3B). Occasional intranuclear pseudo-inclusions were seen (Figure 3C).
case_images: (A) Neoplastic cells showing cytoplasmic positivity for CD34 immunostain (x400 magnification). (B) Neoplastic cells showing focal cytoplasmic positivity for CD117 immunostain (x400 magnification). (C) Neoplastic cells showing nuclear and cytoplasmic positivity for GATA3 immunostain (x400 magnification). (D) Neoplastic cells showing cytoplasmic positivity for smooth muscle actin (x400 magnification).
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case_images: dc25422-fig-0004
case_images: Immunostains showed that neoplastic cells were positive for CD34 (Figure 4A), CD117 (focal, Figure 4B), GATA3 (Figure 4C), smooth muscle actin (Figure 4D), and vimentin, and were negative for pancytokeratin, PAX8, DOG1, INSM1, synaptophysin, HMB45, and Melan-A.