Presented by Dr. Pedram Argani and prepared by Dr. Harsimar Kaur
This is a 45 year old female with a renal mass.
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1. Question
This is a 45 year old female with a renal mass.
Correct
Answer: D
Histologic Description: This an unusual lesion with features heavy classification and ossification at its rim and internally. The neoplastic cells are set in a very hyalinized stroma, and have a nondescript eosinophilic cytoplasm. They form tubules with focal papillary areas. The neoplastic cells were immunoreactive for TFE3 and cathepsin K, and FISH confirmed a TFE3 rearrangement.
Differential Diagnosis: Heterotopic ossification would not contain the proliferated neoplastic epithelial component of the current case. Tubulocystic carcinoma could be suggested by the prominent tubular architecture and focally elastotic stroma; however, the extensive ossification is not typical of that lesion, and the diffuse cathepsin K immunoreactivity also excludes it. Carcinosarcoma is suggested by the prominent osseous component; however, the osseous component is histologically benign and metaplastic.
Xp11 translocation RCC may have variety of histologic patterns. One of the features occasionally seen is heavy eggshell-like classification and ossification, which can lead to the tumor being taken for a renal stone.
Incorrect
Answer: D
Histologic Description: This an unusual lesion with features heavy classification and ossification at its rim and internally. The neoplastic cells are set in a very hyalinized stroma, and have a nondescript eosinophilic cytoplasm. They form tubules with focal papillary areas. The neoplastic cells were immunoreactive for TFE3 and cathepsin K, and FISH confirmed a TFE3 rearrangement.
Differential Diagnosis: Heterotopic ossification would not contain the proliferated neoplastic epithelial component of the current case. Tubulocystic carcinoma could be suggested by the prominent tubular architecture and focally elastotic stroma; however, the extensive ossification is not typical of that lesion, and the diffuse cathepsin K immunoreactivity also excludes it. Carcinosarcoma is suggested by the prominent osseous component; however, the osseous component is histologically benign and metaplastic.
Xp11 translocation RCC may have variety of histologic patterns. One of the features occasionally seen is heavy eggshell-like classification and ossification, which can lead to the tumor being taken for a renal stone.
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