case_images: PMC10984609_01
case_images: Gross view of both kidneys - A view of the kidneys following the removal of perirenal fat reveals the presence of extensive hemorrhagic infiltration on the surface of both kidneys, especially on the right one. Scale bar= 5 cm. (right kidney (R) exhibits the most extensive hemorrhagic component).
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case_images: Further exploration of the retroperitoneal and renal spaces evidenced a bilateral perirenal blood collection (700 mL on the right and 250mL on the left) with hemorrhagic infiltration of the perirenal adipose tissue and the renal capsule, bilaterally (Figure 1).
case_images: Macroscopic features of kidneys. A - The kidney surface is lobulated and enlarged with a brown-yellow color; B - The right kidney's cleavage surface shows that the parenchyma has been largely replaced by newly formed solid and yellowish tissue (scale bars= 5 cm).
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case_images: Photomicrographs of the kidney. A and B - Neoplastic tissue consisting of mature adipose tissue, with proliferation of smooth muscle tissue, newly formed vessels, and neoplastic cells with irregular nuclei increased of size (H&E original magnification 40x (A) and 100x (B)); C - Smooth muscle actin immunostaining confirmed the muscular component of the neoplasia (original magnification 40x); D - HMB45 immunohistochemistry staining was performed showing heterogeneous positivity in adipose cells, confirming the diagnosis of renal angiomyolipoma (original magnification 100x).
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case_images: PMC10984609_01_autopsy-14-e2024482-g03.jpg
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case_images: The microscopical examination of the renal samples rendered the diagnosis of bilateral angiomyolipoma, with blood congestion of the residual normal parenchyma (Figures 3A and 3B). Immunostaining confirmed the muscular and adipose components of the neoplasia (Figures 3C and 3D).