PMC3649601_01
Gross Pathological Findings: Cut surface of the kidney shows that the tumour was firm grey white, 7.5 x 5.5 x 4.5 cm in size, replacing most of the kidney
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F1
The neoplasm appeared to abut the pelvis but there was no infiltration into pelvic or perirenal fat [Figure 1].
Microphotograph of neoplasm showing slightly nodular architecture due to varying cellularity and was composed of spindle cells with thin tapered bland nuclei an indistinct cytoplasm (hematoxylin and eosin stain, x100)
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F2
Microscopically the tumour had a slightly nodular architecture due to varying cellularity and was composed of spindle cells with thin tapered bland nuclei an indistinct cytoplasm [Figure 2].
Microphotograph of neoplasm showing concentric arrangement around entrapped tubules, imparting 'onion skin appearance' (hematoxylin and eosin stain, x200)
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F3
Focally, a concentric arrangement around entrapped tubules and vessels, imparting 'the onion skin' morphology, was noted [Figure 3].
Microphotograph of neoplasm showing well demarcation from the adjacent kidney but without a definite capsule (hematoxylin and eosin stain, x200)
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F4
The tumour was well demarcated from the adjacent kidney, but without a definite capsule [Figure 4].
Microphotograph of neoplasm showing blood vessels having hypercellularity around endothelium with thickened walls but there were no features of dysplasia (H and E stain, x200)
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F5
Some blood vessels showed hypercellularity around the endothelium with thickened walls but there were no features of dysplasia [Figure 5].
Immunohistochemical staining for CD 34 showing focal positivity (x200)
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F6
On immunohistochemistry, the cells were positive for Vimentin, focally positive for CD-34 [Figure 6] and negative for WT-1, Desmin and Smooth muscle actin.