PMC3546909_01
Axial computed tomography image after intravenous contrast enhancement reveals an intraluminal pedunculated hyperdense enhancing mass in the gallbladder without thickening of the gallbladder wall.
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F1
The tumor seemed to be attached to the edge of the liver with no macroscopic extension to the liver parenchyma (Figure 1).
Axial computed tomography image after intravenous contrast enhancement shows a cortical fleshy nodule of the right kidney with no involvement of the perinephric adipose.
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F2
TDM scan showed a cortical fleshy nodule of the right kidney, measuring 2.2 cm, with no involvement of the perinephric adipose (Figure 2). The biliary symptoms and pedunculated appearance of the tumor on the TDM scan suggested a possible diagnosis of primary carcinoma of the gallbladder.
Representative micrograph shows that the polyp is composed of clear cell renal cell carcinoma in a background of normal gallbladder (Hematoxylin-eosin, original magnification x4).
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F3
Histologically, the polyp consisted of clear cells with delicate arborizing capillary vascular network, consistent with a metastatic conventional clear cell renal cell carcinoma (Figure 3).
Representative micrograph of the polyp: The tumor is composed of clear cells disposed in alveolar pattern with delicate arborizing capillary vascular network. (Hematoxylin-eosin, original magnification x10).
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F4
The nucleus was round and uniform, with finely granular, evenly distributed chromatin (Figure 4).
Immunohistochemical stain: The tumor cells are positive for CD10.
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F5
Diagnosis of metastatic renal cell carcinoma (RCC) was confirmed by immunohistochemical stains, which showed the tumor cells to be positive for CD10 (Figure 5), vimentin (Figure 6) and pancytokeratin, but negative for CK7, carcinoembryonic antigen (CEA), chromogranin, synaptophysin and CD68.
Immunohistochemical stain: The tumor cells are positive for vimentin.
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F6
Diagnosis of metastatic renal cell carcinoma (RCC) was confirmed by immunohistochemical stains, which showed the tumor cells to be positive for CD10 (Figure 5), vimentin (Figure 6) and pancytokeratin, but negative for CK7, carcinoembryonic antigen (CEA), chromogranin, synaptophysin and CD68.
Clear cell renal cell carcinoma of the kidney (Hematoxylin-eosin, original magnification x4).
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F7
The histological study revealed a typical conventional clear cell RCC, Fuhrman nuclear grade 3, with negative surgical resection margins (Figure 7).