Case 3

Clinical history

55 year old woman, renal mass.

Primary image

Intermediate magnification. H&E stain.

High magnification
High magnification. H&E stain.

Very high magnification
Very high magnification. H&E stain.

Additional tests

More history

More history
Sister had a renal tumour. Biopsy diagnosis was clear cell renal cell carcinoma.

Ask a friend

Ask a friend
There is one immunostain I think would be really useful here. If I am right, this case may have the chromosomal translocation seen in alveolar soft part sarcoma.

Stains

Alcian blue/PAS to Bilirubin Test Result Alcian blue/PAS Dr T would ask why! Alican blue pH 1.0 Dr T would ask why! Alcian blue pH 2.5 Dr T would ask why! Auramine Dr T would ask why! Bielchowsky Dr T would ask why! Bilirubin Dr T would ask why!	Colloidal iron to Fontana-Masson Test Result Colloidal iron Dr T would ask why! Congo red Dr T would ask why! Cresyl violet Dr T would ask why! Dieterle Dr T would ask why! Diff Quik Dr T would ask why! Fontana-Masson Dr T would ask why!	Gallyas to Gremelius Test Result Gallyas Dr T would ask why! Giemsa Dr T would ask why! GMS Dr T would ask why! Gomori's trichrome Dr T would ask why! Gram Dr T would ask why! Gremelius Dr T would ask why!	JMS to Mucicarmine Test Result JMS Dr T would ask why! Jones Dr T would ask why! Kinyoun Dr T would ask why! Luxol fast blue Dr T would ask why! Masson trichrome Dr T would ask why! M-MAS Dr T would ask why! Movat Dr T would ask why! Mucicarmine Dr T would ask why!	Oil red O to Prussian blue Test Result Oil red O Dr T would ask why! Orecein Dr T would ask why! PAS Dr T would ask why! PASD Dr T would ask why! PASF Dr T would ask why! PTAH Dr T would ask why! Prussian blue Dr T would ask why!	Reticulin to Ziehl-Neelsen Test Result Reticulin Dr T would ask why! Sudan black B Dr T would ask why! Toluidine blue Dr T would ask why! Verhoeff Dr T would ask why! Von Kossa Dr T would ask why! Warthin-Starry Dr T would ask why! Ziehl-Neeslen Dr T would ask why!

IHC

Alpha-1 AT to Cathepsin K Test Result alpha-1 AT Dr Torres would ask why! ACTH Dr Torres would ask why! AE1/AE1 Dr Torres would ask why! alpha-fetoprotein Dr Torres would ask why! Alk-I Dr Torres would ask why! AMACR Dr Torres would ask why! AR Dr Torres would ask why! ATRX Dr Torres would ask why! Beta2-microglobulin Dr Torres would ask why! B72.3 Dr Torres would ask why! Beta-catenin Dr Torres would ask why! BCL2 Dr Torres would ask why! BCL6 Dr Torres would ask why! BCLxL Dr Torres would ask why! C3 comp Dr Torres would ask why! CA9 Dr Torres would ask why! Calcitonin Dr Torres would ask why! Calponin Dr Torres would ask why! Calretinin Dr Torres would ask why! CAM5.2 Dr Torres would ask why! Cathepsin K Dr Torres would ask why!	CD10 to Chromogranin Test Result CD10 POSITIVE CD117 Dr Torres would ask why! CD138 Dr Torres would ask why! CD15 Dr Torres would ask why! CD1a Dr Torres would ask why! CD20 Dr Torres would ask why! CD21 Dr Torres would ask why! CD23 Dr Torres would ask why! CD3 Dr Torres would ask why! CD30 Dr Torres would ask why! CD31 Dr Torres would ask why! CD34 Dr Torres would ask why! CD35 Dr Torres would ask why! CD4 Dr Torres would ask why! CD43 Dr Torres would ask why! CD45 (LCA) Dr Torres would ask why! CD5 Dr Torres would ask why! CD56 Dr Torres would ask why! CD57 Dr Torres would ask why! CD68 Dr Torres would ask why! CD7 Dr Torres would ask why! CD79a Dr Torres would ask why! CD8 Dr Torres would ask why! CD99 Dr Torres would ask why! CDX2 Dr Torres would ask why! CEA-m Dr Torres would ask why! Chromogranin Dr Torres would ask why!	CK17 to Glypican 3 Test Result CK17 Dr Torres would ask why! CK19 Dr Torres would ask why! CK20 Dr Torres would ask why! CK34betaE12 Dr Torres would ask why! CK5/6 Dr Torres would ask why! CK7 NEGATIVE CMV Dr Torres would ask why! c-MYC Dr Torres would ask why! Cyclin D1 Dr Torres would ask why! D2-40 Dr Torres would ask why! Desmin Dr Torres would ask why! DOG1 Dr Torres would ask why! EBV Dr Torres would ask why! EMA Dr Torres would ask why! ER and PR Dr Torres would ask why! Factor VIII Dr Torres would ask why! Factor XIIIa Dr Torres would ask why! Fascin Dr Torres would ask why! FH Dr Torres would ask why! FSH Dr Torres would ask why! Gastrin Dr Torres would ask why! GATA3 Dr Torres would ask why! GCDFP-15 (BRST2) Dr Torres would ask why! GFAP Dr Torres would ask why! GH Dr Torres would ask why! Glucagon Dr Torres would ask why! Glypican-3 Dr Torres would ask why!	HBME-1 to IgM Test Result HBME-1 Dr Torres would ask why! HBV core Dr Torres would ask why! HBV surface Dr Torres would ask why! H-caldesmon Dr Torres would ask why! HCG Dr Torres would ask why! Helicobacter Dr Torres would ask why! Hepatocyte Dr Torres would ask why! HER2/neu Dr Torres would ask why! HHV-8 Dr Torres would ask why! HMB-45 NEGATIVE HNF1beta Dr Torres would ask why! HPV Dr Torres would ask why! HSV-I Dr Torres would ask why! HSV-II Dr Torres would ask why! IDH-1 Dr Torres would ask why! Inhibin Dr Torres would ask why! INI1 (BAF47) Dr Torres would ask why! Insulin Dr Torres would ask why! Kappa Dr Torres would ask why! Ki-67 Dr Torres would ask why! Lambda Dr Torres would ask why! Leu 7 Dr Torres would ask why! IgA Dr Torres would ask why! IgG Dr Torres would ask why! IgM Dr Torres would ask why!	LH to PDGFR Test Result LH Dr Torres would ask why! LIN28 Dr Torres would ask why! Lysozyme Dr Torres would ask why! mammoglobin Dr Torres would ask why! MAP2 Dr Torres would ask why! MCV Dr Torres would ask why! Melanin A Dr Torres would ask why! MHC class I Dr Torres would ask why! MITF Dr Torres would ask why! MUM1 Dr Torres would ask why! Myeloperoxidase Dr Torres would ask why! MYO D1 Dr Torres would ask why! Myoglobin Dr Torres would ask why! Napsin Dr Torres would ask why! NF Dr Torres would ask why! NKX3.1 Dr Torres would ask why! NSE Dr Torres would ask why! OCT3/4 Dr Torres would ask why! p16 Dr Torres would ask why! P501S Dr Torres would ask why! p53 Dr Torres would ask why! p57 Dr Torres would ask why! p63 Dr Torres would ask why! Pankeratin Dr Torres would ask why! PAX2 Dr Torres would ask why! PAX5 Dr Torres would ask why! PAX8 Dr Torres would ask why! PCNA Dr Torres would ask why! PDGFR Dr Torres would ask why!	PLAP to WT1 Test Result PLAP Dr Torres would ask why! PNL-2C Dr Torres would ask why! Prolactin Dr Torres would ask why! PSA Dr Torres would ask why! PSAP Dr Torres would ask why! RCC Dr Torres would ask why! S-100 Dr Torres would ask why! SALL4 Dr Torres would ask why! Smooth muscle actin Dr Torres would ask why! Somatostatin Dr Torres would ask why! STAT6 Dr Torres would ask why! Synaptophysin Dr Torres would ask why! TdT Dr Torres would ask why! TFE3 POSITIVE TFEB Dr Torres would ask why! Thyroglobulin Dr Torres would ask why! Toxoplasma Dr Torres would ask why! TSH Dr Torres would ask why! TTF-1 Dr Torres would ask why! Ubiquitin Dr Torres would ask why! UCHL1 (PGP9.5) Dr Torres would ask why! Ulex Europaeus Dr Torres would ask why! Vimentin POSITIVE VIP Dr Torres would ask why! VZV Dr Torres would ask why! WT-1 Dr Torres would ask why!

Chromosomal translocations

Translocations Chr 1-10 Test Result t(1;13) PAX7-FKHR Dr Torres would ask why! t(2,13) PAX3-FKHR Dr Torres would ask why! t(8;14) MYC-IGH Dr Torres would ask why! t(9;22) BCR-ABL Dr Torres would ask why! t(9;22) CHN-EWS Dr Torres would ask why!	Translocations Chr 11-13 Test Result t(11;14) CCND1-IGH Dr Torres would ask why! t(11;22) EWS-WT1 Dr Torres would ask why! t(11;22) FLI1-EWS Dr Torres would ask why! t(12;15) ETV6-NTRK3 Dr Torres would ask why! t(12;16) FUS-ATF1 Dr Torres would ask why! t(12;16) CHOP-TLS Dr Torres would ask why! t(12;22) EWS-ATF1 Dr Torres would ask why!	Translocations Chr 14-22 Test Result t(14,18) IGH-BCL2 Dr Torres would ask why! t(15;17) PML-RARA Dr Torres would ask why! t(16;21) FUS-ERG Dr Torres would ask why! t(17;22) COLA1-PDGFB Dr Torres would ask why! t(21;22) EWS-ERG Dr Torres would ask why!	Translocations Chr X & Y Test Result t(X;1) PRCC-TFE3 NOT IDENTIFIED t(X;17) TFE3-ASPL PRESENT t(X;18) SYT-SSX Dr Torres would ask why!

Diagnosis

Diagnosis
Xp11 translocation renal cell carcinoma Comment: These tumours are in the MiT family translocation renal cell carcinoma. They are a relatively common form of renal cell carcinoma in children; however, they are uncommon in adults. In adults they tend to have a poor prognosis.