Date of Presentation:3/24/2021

Attending pathologist: Anil Parwani, MD, PhD

Presented by: Bindu Challa, MD

Prepared by: Bindu Challa, MD

Organ:Kidney

HISTORY:

A male patient in his early 20s presents with right flank pain and gross hematuria. CT abdomen and pelvis showed a mass in lower pole of right kidney. MRI abdomen showed heterogenous, irregular, hypovascular mass measuring 4.4cm x 3.4 cm x 3.4 cm and mild hydronephrosis in right kidney.

GROSS:

Gross image of kidney
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue

Immunohistochemical stains were also positive for FH, SDHB, HNF1, AE1/AE3 (weak,focal), PAX8, INI1 and negative for OCT3/4 and CK7.

What is the most likely diagnosis?

  1. Clear cell renal cell carcinoma
  2. Clear cell papillary renal cell carcinoma
  3. Renal cell carcinoma, MITF/TFE3 family translocation associated subtype
  4. Epithelioid angiomyolipoma
  5. Clear cell sarcoma
Renal cell carcinoma, MITF/TFE3 family translocation associated subtype

CASE SUMMARY