CASE 67 (September 2011)
The patient is a 49-year-old woman in whom detected a mass of 4.2 cm in the upper pole of the left kidney. A nephrectomy was performed. On gross examination the mass was a solid lesion, limited to the kidney, with well-defined limits, but not encapsulated, and without compromise of the hilium. There were not other lesions.
This case was received for consultation, and we have no gross images.
See the histological features and immunohistochemistry.
Figure 1. H&E, X100.
Figure 2. H&E, X200.
Figure 3. H&E, X400.
Figure 4. H&E, X200.
Figure 5. H&E, X400.
Figure 6. Immunohistochemistry (IHC) for cytokeratin coktail, X400.
Figure 7. IHC for smooth muscle actin, X400.
Figure 8. IHC for CD34, X400.
Figure 9. IHC for HMB-45, X400.
Figure 10. IHC for Ki67, X400. Proliferative index: 1%.
Figure 11. IHC for ALK1: negative; for Desmin: negative; for EMA: negative; for S-100: focal positivity. All X400.
What is your diagnosis?