PMC5645085_01
MRI abdomen with and without contrast. Caption: MRI abdomen with and without contrast showing solid and cystic contrast-enhancing right renal masses along with an innumerable number of right renal cysts, many of which containing proteinaceous/hemorraghic contents.
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April of 2016 revealed 9 solid and cystic, contrast-enhancing masses in his remaining right kidney, heightening the concern for RCC (Fig. 1). Also, the numerous cysts contained proteinaceous/hemorrhagic contents consistent with his assumed PKD.
Histology Photo. Caption: (A) At low magnification, papillary structures are seen projecting into the cystic spaces which contain eosinophilic material. Epithelial cells lining the cysts and papillae have clear cytoplasm. (B) At high magnification, solid areas of the tumor contain epithelial cells with a tubular growth pattern, clear cytoplasm, and low grade nuclei which are arranged in a "picket-fence' like configuration, the latter is a classic feature for clear cell tubulopapillary renal cell carcinoma.
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The neoplasms showed prominent tubular architecture, low-grade tumor cells demonstrating a 'picket-fence' like arrangement, and clear cytoplasm, consistent with CCTP-RCC (Fig. 2).
Gross Photo. Caption: Showing cut sections of the kidney with multifocal clear cell tubulopapillary renal cell carcinoma containing numerous solid and cystic areas, mimicking polycystic kidney disease.
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Instead the numerous cystic tumors mimicked the appearance of PKD (Fig. 3).