case_images: PMC3271452_01
case_images: (a) CT scan KUB showing a solid soft tissue density mass inseparable from the medial wall of the left kidney. (b) Gross photograph showing a well-circumscribed, lobulated, grayish white, firm mass with whorled appearance in the lower pole, reaching up to the capsule and displacing the pelvis. (c and d) Photomicrograph of the kidney tumor, composed predominantly of spindle cells with few scattered bizarre cells, arranged in bundles, interlacing fascicles and whorls
case_images: UA-4-48-g001.jpg
case_images: PMC3271452_01_UA-4-48-g001.jpg
case_images: F1
case_images: The lesion was causing extrinsic pressure effect on the pelvi-calyceal system and ureter, resulting in an upward/outward displacement and dilatation [Figure 1a]. It had a characteristic whorled appearance [Figure 1b]. Microscopically, a well-demarcated, circumscribed and lobulated tumor, composed predominantly of spindle cells, arranged in bundles, interlacing fascicles and whorls [Figure 1c and d] was seen.
case_images: Immunohistochemistry showing tumor cells with diffuse and strong positivity with smooth muscle actin (SMA) and desmin. Epithelial membrane antigen (EMA) is focally positive while cytokeratin (CK) is negative
case_images: UA-4-48-g002.jpg
case_images: PMC3271452_01_UA-4-48-g002.jpg
case_images: F2
case_images: Epithelial membrane antigen (EMA) was focally positive, while pancytokeratin and high-molecular weight cytokeratin (34beta E12) were negative [Figure 2].