Case 4

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Clinical history

62 year old woman, renal mass.

Primary image

Clear cell papillary renal cell carcinoma - high mag.jpg
High magnification. H&E stain.
Very high magnification 
Clear cell papillary renal cell carcinoma - very high mag.jpg
High magnification. H&E stain.

Differential diagnosis

Differential diagnosis 
clear cell papillary renal cell carcinoma, clear cell renal cell carcinoma, chromophobe renal cell carcinoma, epithelioid angiomyolipoma, Xp11.2 translocation carcinoma

Additional tests

More history

More history 
Patient is obese and has diabetes.

Ask a friend

Ask a friend 
The location of the nucleus is different. I wonder if this is one of those new RCC types.

Stains

Alcian blue/PAS to Bilirubin
Test Result
Alcian blue/PASDr T would ask why!
Alican blue pH 1.0Dr T would ask why!
Alcian blue pH 2.5Dr T would ask why!
AuramineDr T would ask why!
BielchowskyDr T would ask why!
BilirubinDr T would ask why!
Colloidal iron to Fontana-Masson
Test Result
Colloidal ironDr T would ask why!
Congo redDr T would ask why!
Cresyl violetDr T would ask why!
DieterleDr T would ask why!
Diff QuikDr T would ask why!
Fontana-MassonDr T would ask why!
Gallyas to Gremelius
Test Result
GallyasDr T would ask why!
GiemsaDr T would ask why!
GMSDr T would ask why!
Gomori's trichromeDr T would ask why!
GramDr T would ask why!
GremeliusDr T would ask why!
JMS to Mucicarmine
Test Result
JMSDr T would ask why!
JonesDr T would ask why!
KinyounDr T would ask why!
Luxol fast blueDr T would ask why!
Masson trichromeDr T would ask why!
M-MASDr T would ask why!
MovatDr T would ask why!
MucicarmineDr T would ask why!
Oil red O to Prussian blue
Test Result
Oil red ODr T would ask why!
OreceinDr T would ask why!
PASDr T would ask why!
PASDDr T would ask why!
PASFDr T would ask why!
PTAHDr T would ask why!
Prussian blueDr T would ask why!
Reticulin to Ziehl-Neelsen
Test Result
ReticulinDr T would ask why!
Sudan black BDr T would ask why!
Toluidine blueDr T would ask why!
VerhoeffDr T would ask why!
Von KossaDr T would ask why!
Warthin-StarryDr T would ask why!
Ziehl-NeeslenDr T would ask why!

IHC

Alpha-1 AT to Cathepsin K
Test Result
alpha-1 AT Dr T would ask why!
ACTH Dr T would ask why!
AE1/AE1Dr T would ask why!
alpha-fetoprotein Dr T would ask why!
Alk-I Dr T would ask why!
AMACRNEGATIVE
ARDr T would ask why!
ATRXDr T would ask why!
Beta2-microglobulin Dr T would ask why!
B72.3 Dr T would ask why!
Beta-cateninDr T would ask why!
BCL2 Dr T would ask why!
BCL6 Dr T would ask why!
BCLxL Dr T would ask why!
C3 comp Dr T would ask why!
CA9Dr T would ask why!
Calcitonin Dr T would ask why!
Calponin Dr T would ask why!
Calretinin Dr T would ask why!
CAM5.2Dr T would ask why!
Cathepsin KDr T would ask why!
CD10 to Chromogranin
Test Result
CD10 NEGATIVE
CD117 Dr T would ask why!
CD138Dr T would ask why!
CD15 Dr T would ask why!
CD1a Dr T would ask why!
CD20 Dr T would ask why!
CD21 Dr T would ask why!
CD23 Dr T would ask why!
CD3 Dr T would ask why!
CD30 Dr T would ask why!
CD31 Dr T would ask why!
CD34 Dr T would ask why!
CD35 Dr T would ask why!
CD4 Dr T would ask why!
CD43 Dr T would ask why!
CD45 (LCA)Dr T would ask why!
CD5 Dr T would ask why!
CD56 Dr T would ask why!
CD57Dr T would ask why!
CD68 Dr T would ask why!
CD7 Dr T would ask why!
CD79a Dr T would ask why!
CD8 Dr T would ask why!
CD99 Dr T would ask why!
CDX2Dr T would ask why!
CEA-m Dr T would ask why!
Chromogranin Dr T would ask why!
CK17 to Glypican 3
Test Result
CK17Dr T would ask why!
CK19Dr T would ask why!
CK20 Dr T would ask why!
CK34betaE12 Dr T would ask why!
CK5/6Dr T would ask why!
CK7 POSITIVE
CMV Dr T would ask why!
c-MYC Dr T would ask why!
Cyclin D1 Dr T would ask why!
D2-40Dr T would ask why!
Desmin Dr T would ask why!
DOG1Dr T would ask why!
EBV Dr T would ask why!
EMADr T would ask why!
ER and PR Dr T would ask why!
Factor VIII Dr T would ask why!
Factor XIIIa Dr T would ask why!
Fascin Dr T would ask why!
FHDr T would ask why!
FSH Dr T would ask why!
Gastrin Dr T would ask why!
GATA3Dr T would ask why!
GCDFP-15 (BRST2)Dr T would ask why!
GFAPDr T would ask why!
GH Dr T would ask why!
Glucagon Dr T would ask why!
Glypican-3Dr T would ask why!
HBME-1 to IgM
Test Result
HBME-1 Dr T would ask why!
HBV core Dr T would ask why!
HBV surface Dr T would ask why!
H-caldesmonDr T would ask why!
HCG Dr T would ask why!
HelicobacterDr T would ask why!
Hepatocyte Dr T would ask why!
HER2/neu Dr T would ask why!
HHV-8Dr T would ask why!
HMB-45Dr T would ask why!
HNF1betaDr T would ask why!
HPV Dr T would ask why!
HSV-I Dr T would ask why!
HSV-II Dr T would ask why!
IDH-1Dr T would ask why!
Inhibin Dr T would ask why!
INI1 (BAF47)Dr T would ask why!
Insulin Dr T would ask why!
Kappa Dr T would ask why!
Ki-67 Dr T would ask why!
Lambda Dr T would ask why!
Leu 7 Dr T would ask why!
IgA Dr T would ask why!
IgG Dr T would ask why!
IgM Dr T would ask why!
LH to PDGFR
Test Result
LH Dr T would ask why!
LIN28 Dr T would ask why!
Lysozyme Dr T would ask why!
mammoglobinDr T would ask why!
MAP2Dr T would ask why!
MCVDr T would ask why!
Melanin A Dr T would ask why!
MHC class I Dr T would ask why!
MITFDr T would ask why!
MUM1Dr T would ask why!
Myeloperoxidase Dr T would ask why!
MYO D1 Dr T would ask why!
MyoglobinDr T would ask why!
NapsinDr T would ask why!
NFDr T would ask why!
NKX3.1Dr T would ask why!
NSE Dr T would ask why!
OCT3/4Dr T would ask why!
p16Dr T would ask why!
P501SDr T would ask why!
p53 Dr T would ask why!
p57Dr T would ask why!
p63 Dr T would ask why!
PankeratinDr T would ask why!
PAX2Dr T would ask why!
PAX5Dr T would ask why!
PAX8Dr T would ask why!
PCNA Dr T would ask why!
PDGFRDr T would ask why!
PLAP to WT1
Test Result
PLAP Dr T would ask why!
PNL-2C Dr T would ask why!
Prolactin Dr T would ask why!
PSA Dr T would ask why!
PSAPDr T would ask why!
RCCDr T would ask why!
S-100Dr T would ask why!
SALL4Dr T would ask why!
Smooth muscle actin Dr T would ask why!
Somatostatin Dr T would ask why!
STAT6 Dr T would ask why!
Synaptophysin Dr T would ask why!
TdT Dr T would ask why!
TFE3Dr T would ask why!
TFEBDr T would ask why!
Thyroglobulin Dr T would ask why!
Toxoplasma Dr T would ask why!
TSH Dr T would ask why!
TTF-1 Dr T would ask why!
Ubiquitin Dr T would ask why!
UCHL1 (PGP9.5)Dr T would ask why!
Ulex Europaeus Dr T would ask why!
VimentinDr T would ask why!
VIP Dr T would ask why!
VZV Dr T would ask why!
WT-1Dr T 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-IGHDr 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-TFE3Dr Torres would ask why!
t(X;17) TFE3-ASPL Dr Torres would ask why!
t(X;18) SYT-SSX Dr Torres would ask why!


Diagnosis

Diagnosis 
Clear cell papillary renal cell carcinoma


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