PMC10063962_01
Colour ultrasound. This image shows a moderate echogenic mass of approximately 2.6 cmx2.3 cm in the middle and upper parts of the left kidney, with a clear boundary and regular shape [yellow+ and green+]. CDFI: no blood flow signal in the mass.
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Urological ultrasound showed a moderate echogenic mass of approximately 2.6 cmx2.3 cm in the middle and upper parts of the left kidney, with a clear boundary and regular shape and no blood flow signal ( Figure 1 ).
Computed tomography. These images show a 2.4 cmx2.2 cm equal-density mass in the anterior upper part of the left kidney, with poorly defined margins and a calcium density shadow in the mass [(A), red arrow]. The enhancement scan shows inhomogeneous enhancement [(B, C), red arrow].
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Abdominal CT showed a left renal mass, and renal clear cell carcinoma was considered ( Figure 2 ).
Pathology and immunohistochemistry. The tumour is well demarcated and has a complex branched papillary structure with a fibrous vascular axis [H&E, 40x (A)]; The surface is covered with a monolayer of cuboidal or columnar cells, with eosinophilic cytoplasm and characteristic nuclei located at the top of the cytoplasm away from the basement membrane [H&E, 100x (B)]. The tumour cells expressed keratin 7 diffusely and strongly [immunohistochemistry, 40x (C)]; GATA3 was diffusely expressed in tumour nuclei [immunohistochemistry, 100x (D)].
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Histopathological studies of the resected tumour revealed the tumour was well demarcated and had a complex branched papillary structure with a fibrous vascular axis, and the papillary surface was covered with a monolayer of cuboidal or columnar cells, with eosinophilic cytoplasm and characteristic nuclei located at the top of the cytoplasm away from the basement membrane ( Figures 3A, B ). TG ( Figures 3C, D ). Histomorphology and immunophenotype were consistent with papillary renal neoplasm with reverse polarity.