Combined Papillary Renal Cell Carcinoma with Neuroendocrine Differentiation and Mucinous Tubular and Spindle Cell Carcinoma

Figure 2

Photomicrographs of the primary kidney tumour. (a) There were two distinct morphologies. The main tumour showed a prominent papillary structure, eosinophilic cytoplasm, Fuhrman grade 3 nuclei (left). The smaller focus of tumour showed long tubular profiles or cord-like growth pattern of uniform, bland, low cuboidal cells with eosinophilic, focally vacuolated cytoplasm which transition to anastomosing spindle cells, with stroma showing myxoid and bubbly with abundant extracellular mucin (right). (b) The PRCC component showed positive staining for CD10 (left). The MTSCC component was negative for CD10 (right). (c) The PRCC component had small foci positive for synaptophysin. (d) Fluorescent in situ hybridization analysis showing three centromere 17 signals consistent with trisomy 17 in the PRCC component (left, green dots), while the MTSCC component was negative for trisomy 17 (right, green dots).

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