case_images: PMC5954322_01
case_images: Native right kidney, removed at the time of transplantation. (a) The kidney
  was enlarged with an irregular cortical surface and numerous, variable sized
  fluid-filled cysts. The cysts were compatible with polycystic kidney
  disease. Although no distinct neoplastic masses were identified grossly,
  abundant firm, white-tan tissue separated the cysts and regionally replaced
  the renal parenchyma (*). (b) Despite intraoperative cytology suggestive of
  inflammation, histology of the renal parenchyma identified an infiltrative
  neoplasm composed of tubules and small islands of neoplastic epithelial
  cells amid an abundant desmoplastic stroma. Cellular and nuclear
  pleomorphism was marked, and mitoses were frequent. These features were
  consistent with a renal cell carcinoma in the right native kidney
case_images: 10.1177_2055116918766152-fig1.jpg
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case_images: These histologic features were consistent with a renal cell carcinoma (RCC) (Figure 1a,b).
case_images: Inguinal and perineal skin. (a) The skin was erythematous with multifocal
  erosions and ulcers. (b) Histologically, there were large areas of epidermal
  and dermal necrosis with suppurative inflammation extending throughout the
  dermis into the subcutis. (c) Dermal and subcutaneous blood vessels
  frequently contained fibrin thrombi
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case_images: Blood vessels in these sections often contained fibrin thrombi, exhibited fibrinoid vascular necrosis and occasionally necrotizing vasculitis (Figure 2a-c).
case_images: The digital and metatarsal pads of the left pelvic limb were erythematous (*)
  and the skin distal to the tarsus was hyperemic
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case_images: Similar lesions were identified in the digital and metatarsal pads of the left pelvic limb during necropsy (Figure 3).
case_images: Caudal to the liver (L), there was an anomalous bifurcation (white arrow) of
  the caudal vena cava (CVC) at the level of the adrenal glands. Distal to the
  bifurcation, the right branch of the caudal vena cava was regionally
  thickened and contained a luminal fibrin thrombus (black arrowhead) at
  post-mortem examination. Hemoclips and sutures surrounded the right renal
  vein, artery and anastomosing vessels at the site of nephrectomy of the
  right native kidney (*)
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case_images: TE disease, multifocal acute intravascular fibrin thrombi were distributed throughout multiple other tissues, including the allograft kidney, heart, right adrenal gland and one of the anomalous branches of the caudal vena cava (Figure 4). The allograft kidney had multiple fibrin thrombi within the vessels of the renal cortex and corticomedullary junction and foci of segmental acute tubular necrosis with tubular casts (Figure 5a,b).
case_images: Left allograft kidney. (a) Multiple tubules were lined by necrotic epithelial
  cells, which were often sloughed into the tubular lumen (*). (b)
  Multifocally, blood vessels contained fibrin thrombi (*)
case_images: 10.1177_2055116918766152-fig5.jpg
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case_images: fig5-2055116918766152
case_images: TE disease, multifocal acute intravascular fibrin thrombi were distributed throughout multiple other tissues, including the allograft kidney, heart, right adrenal gland and one of the anomalous branches of the caudal vena cava (Figure 4). The allograft kidney had multiple fibrin thrombi within the vessels of the renal cortex and corticomedullary junction and foci of segmental acute tubular necrosis with tubular casts (Figure 5a,b).