PMC7718149_01
CT scan images of the (A) lung showing multiple metastatic nodules, (B) bladder mass in the left lateral wall, and (C) infiltrative mass in the upper pole of the right kidney.
gr1.jpg
PMC7718149_01_gr1.jpg
fig1
A CT imaging of abdomen and pelvis with contrast revealed an infiltrative 7.5 cm right upper pole renal mass involving the collecting system with renal vein extension (Fig. 1C). A 2.4 cm sessile bladder mass involving the left lateral wall, with retroperitoneal and left iliac lymphadenopathy was noted (Fig. 1B). Multiple pulmonary nodules were seen in the bilateral lungs, with the largest nodule measuring 1.8 cm (Fig. 1A).
(A) Histopathological examination of one of the collision tumors demonstrating two cellular components: a major clear cell component at the periphery and core representing metastatic clear cell RCC, and a central component with adjacent osseous metaplasia representing the HGUC (25X). (B) Solid sheets of cohesive cells representing the HGUC (200x). (C) Osseous metaplasia with surrounding the clear cell RCC (200x). (D) HGUC cells within the vasculature of the clear cell RCC component (400x).
gr2.jpg
PMC7718149_01_gr2.jpg
fig2
Microscopically, the nodules were composed of two morphologically distinct cellular populations (Fig. 2).
(A) Hematoxylin and eosin (H&E) section showing HGUC component on the left and clear cell RCC on the right. (B) CK-7 staining the HGUC component. (C) CK-20 staining the HGUC component. (D) GATA-3 staining the HGUC component. (E) PAX 8 staining the nuclei of clear cell RCC. (F) TTF-1 showed negative staining in both HGUC and clear cell RCC components. All images examined at 200x.
gr3.jpg
PMC7718149_01_gr3.jpg
fig3
Thyroid transcription factor-1 (TTF-1) stain was negative in both components, ruling out a primary lung carcinoma component (Fig. 3).