PMC3263029_01
CT scan of the abdomen showing a thickened soft tissue rind of perinephric tissue (yellow arrow), infiltration of the retroperitoneum in the paraaortic and interaortocaval spaces (blue arrow), as well as encasement of the superior mesenteric artery (pink arrow)
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F1
There was also infiltration of the adrenal glands and peri-adrenal fat and extensive perivascular infiltration with encasement of the celiac artery, superior mesenteric artery, renal arteries and veins [Figure 1].
Various histiocytes from touch preparations are shown including a) a bland xanthomatous histiocyte, b) binucleated and c) multinucleated histiocyte (600x magnification, Diff-Quik stain). d) A cluster of monomorphic epithelioid histiocytes are shown in the FNA sample (ThinPrep, 600x magnification, Papanicolaou stain).. Note that their nuclei are not grooved and are without pseudoinclusions
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F2
The cytology samples were of low cellularity and demonstrated bland epithelioid histiocytes arranged in clusters as well as individual foamy macrophages and occasional binucleated and multinucleated histiocytes [Figure 2].
Core biopsy from perinephric rind showing dense fibrotic tissue associated with spindle cells and epithelioid foamy histiocytes that are focally clustered (left region of the image). A few scattered small lymphocytes are also present, but no eosinophils or acute inflammatory cells are seen. (200x magnification, H and E stain)
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F3
The core biopsy showed predominantly dense fibrotic tissue associated with bland spindled cells and epithelioid histiocytes that were focally aggregated in loose clusters [Figure 3].
Immunohistochemical work-up of the core biopsy demonstrates that the histiocytes are immunoreactive for a) CD68 (100x magnification), b) Factor XIIIa (200x magnification) and c) CD163 (400x magnification)
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F4