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By Ronald M Bukowski; Andrew C Novick

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Extra info for Renal cell carcinoma : molecular biology, immunology, and clinical management

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6. Chromophobe renal cell carcinoma. The neoplasms often have areas of cells with clear cytoplasm as well as eosinophilic cytoplasm. Cell membranes are prominent (arrow). H&E x400. Fig. 7. Electron micrograph of chromophobe renal cell carcinoma. Microvesicles (arrow) are present in a perinuclear location (x24,000). Patients with grade I nuclei have a relatively lower risk of distant metastasis when compared to patients with grade IV nuclei. The prognosis for patients with grade II or III nuclei are intermediate.

Smooth muscle is the most histologically variable element of AML and may demonstrate marked epithelioid atypia in benign tumors. Eble et al. and Martignoni et al. have described epithelioid variants in patients with and without TS (21,22). This morphology may lead to an incorrect diagnosis of RCC, particularly in a biopsy. PAS-positive diastase-resistant crystalloid structures and granules have been described in AML (23). Immunohistochemical stains are useful in the diagnosis of AML and in distinguishing them from RCC.

Septa may contain epithelial structures resembling mature renal tubules, but no epithelial cells with clear cytoplasm. Septa may not contain skeletal muscle fibers (16). By 1968, eight cases of sarcoma developing in CN were reported. At least three of the patients died of metastases. These sarcomas have been reported as undifferentiated embryonal spindle cell sarcoma (six cases), low-grade leiomyosarcoma (one case), and pleomorphic high-grade sarcoma (16). Other than tumors in which sarcomas have developed, CNs have behaved in a benign fashion.

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