PMC9301116_01
FNAC: low power (10x view) clusters of small round cells with scant
cytoplasm.
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FNAC of the mass was performed and it showed features of fibroliposarcoma (Figure 1).
Gross morphology: Fatty tumour encasing the right kidney.
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Grossly the tumour gave an impression of a liposarcoma but the microscopy was altogether a different story with areas of spindle cells, epitheloid cells, focal areas of ganglion like cells and large areas of myxoid changes (Figure 2).
H & E Staining: low power (10x view) areas of tumour showing spindle
cells and epitheloid cells with occasional scattered cells having large
hyperchromatic nuclei and scant cytoplasm.
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Haematoxylin and eosin staining showed a neoplasm with high cellularity and mostly spindle-shaped cells arranged in storiform pattern (Figure 3).
SMA Negative: high power (40x view) tumour cells are SMA negative, blood
vessels and connective tissues acting as positive control.
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Alk-1 was applied (Figures 4 and 5). All of these IHC panels came negative and increased the complexity and dilemma of diagnosis.
S 100 Negative: high power (40x view) tumour cells are S100 negative.
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Alk-1 was applied (Figures 4 and 5). All of these IHC panels came negative and increased the complexity and dilemma of diagnosis.
MDM2 : high power (40x view) strong nuclear positivity seen in tumour
cells.
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Subsequently other immunostainings such as MDM2, cdk4 and p16 were performed (Figures 6-8).
CDK4: high power (40x view) strong nuclear positivity seen in tumour
cells.
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Subsequently other immunostainings such as MDM2, cdk4 and p16 were performed (Figures 6-8).
p16: high power (40x view) strong nuclear positivity seen in tumour
cells.
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Subsequently other immunostainings such as MDM2, cdk4 and p16 were performed (Figures 6-8).