PMC7309373_01
Bone marrow biopsy revealed a mass of megakaryocytes which were actively proliferated. Two platelet aggregation were noted.
10.1177_2058738420931619-fig1.jpg
PMC7309373_01_10.1177_2058738420931619-fig1.jpg
fig1-2058738420931619
Two platelet aggregations were observed (Figure 1).
(a-d) CT urography revealed a tumor with uneven enhancement (red circle) in the right renal, measuring ~10.3 x 10.4 cm in size. (e, f) MRI revealed a large solid mass projecting from the right kidney with rich blood supply (red circle) and venous tumor thrombui in the right kidney.
10.1177_2058738420931619-fig2.jpg
PMC7309373_01_10.1177_2058738420931619-fig2.jpg
fig2-2058738420931619
CT urography was performed after admission, and it revealed venous tumor thrombui of the right kidney and a space-occupying lesion with uneven enhancement in the right kidney, with 10.3 cm x 10.4 cm in size (Figure 2). A renal enhanced magnetic resonance imaging (MRI) scan revealed a large solid mass projecting from the right kidney with rich blood supply and venous tumor thrombui in the right kidney (Figure 2).
(a, b) CT angiography scan revealed renal venous tumor thrombui and arteriovenous fistula of the right kidney (red symbol). (c, d) Renal artery ultrasound revealed bilateral renal artery presenting negative and swelling of the right renal (rheography).
10.1177_2058738420931619-fig3.jpg
PMC7309373_01_10.1177_2058738420931619-fig3.jpg
fig3-2058738420931619
A renal CT angiography (CTA) scan revealed renal venous tumor thrombui and arteriovenous fistula of the right kidney (Figure 3). Renal artery ultrasound revealed that bilateral renal artery was negative and the right renal was swelling (Figure 3).
(a) Pathology confirmed a diagnosis of renal clear cell cancer of the right renal and the tumor was a Fuhrman grade 3. The tumor cells showed alveolar growth architecture (staining, H&E; magnification, 200x). (b) Pathology revealed necrosis area in the tumors. (c) Immunohistochemistry revealed CD10 (+).
10.1177_2058738420931619-fig4.jpg
PMC7309373_01_10.1177_2058738420931619-fig4.jpg
fig4-2058738420931619
In addition, tumor cells showed alveolar growth architecture and involved renal parenchyma without renal capsule or ureter, which confirmed the diagnosis of renal clear cell cancer of the right renal (Figure 4). The pathology also revealed necrosis area in tumor (Figure 4). I (T2bN0M0). Immunohistochemistry revealed CK (+), Vim (-), RCC (+), CD10(+), PAX-8(+), PAX-2(-), CD117(-), CK7(-), TFE3(-), Ki-67 (+) 5% (Figure 4).