PMC3508530_01
Contrast-enhanced computed tomography showing a homogenously enhanced lenticular tumor from the lateral aspect of the middle pole of the left kidney.
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fig1
The tumor was isodense compared with the healthy renal parenchyma; therefore, it was imaged by contrast-enhanced CT, which revealed a homogeneous mass with well-defined margins and a smooth interface between the mass and kidney (Figure 1).
Coronal T1-weighted magnetic resonance imaging showing a tumor with homogenous low-signal intensity and well-defined margins.
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On both T1- and T2-weighted magnetic resonance (MR) images, the tumor exhibited homogeneous low-signal intensity and well-defined margins (Figure 2), thus appearing benign.
Retroperitoneoscopic view showing tumor excision without hilar clamping. The tumor is attached to the renal cortex by a small peduncle.
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fig3
The tumor was excised through the renal cortex using cold scissors (Figure 3).
Histopathological examination. (a) The tumor is contiguous with the renal capsule (H&E staining, x40). (b) Both epitheloid and spindle cells proliferate in an interlacing fascicular arrangement. No fat cells are present (H&E staining, x100). (c) The epitheloid cells are diffusely and strongly positive for alpha-smooth muscle actin (x100). (d) The spindle cells are focally and weakly positive for HMB-45 (x100).
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fig4
The tumor was contiguous with the renal capsule and did not extend into the perirenal adipose tissue (Figure 4(a)). Histological examination revealed both epitheloid and spindle cells proliferated in an interlacing fascicular arrangement without incorporating renal tubules (Figure 4(b)). Immunohistochemical analysis revealed that the epitheloid cells were diffusely and strongly positive for alpha-smooth muscle actin (Figure 4(c)), whereas the spindle cells were focally and weakly positive for HMB-45 (Figure 4(d)).