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Essential features carbonic anhydrase ix (caix / ca9) is a transmembrane protein (membranous expression) (am j clin pathol 2014;141:219) primarily used in differentiating kidney tumors but not specific to renal primary tumors The tumor histology and variable ck7 positivity raise the possibility of a recently described tceb1 mutated renal cell carcinoma. Sample pathology report right kidney, partial nephrectomy

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Clear cell papillary renal cell tumor, 2.5 cm surgical margins, negative for tumor comment The immunohistochemical stains demonstrate that the neoplastic cells are positive for caix, variably positive for ck7 and cd10 but negative for tfe3 Immunostaining demonstrate diffuse positivity for caix and ck7 and negative staining for cd10 and amacr.

Clear cell rcc is the most common renal epithelial tumor, typically with clear cytoplasm and a compact nested or acinar growth pattern, intersected by delicate vasculature and with alterations to chromosome 3p involving vhl gene inactivation

While the immunohistochemistry profile is not entirely concordant with a renal primary, especially with negative pax8 and caix, the positivity of both cd10 and rcc ma would suggest possibility of renal primary in the context of known history of renal cell carcinoma Clinical and radiological correlation is recommended. Papillary renal cell carcinoma (prcc) is a malignant neoplasm derived from renal tubular epithelium with predominantly papillary or tubulopapillary architecture Benign renal cysts are discrete fluid filled cystic lesions within the kidney parenchyma or at the capsular surface

Coexpression of caix / ck7 plus variable expression of hmwck and gata3 are typically seen in clear cell papillary renal cell tumor (b) Conventional clear cell rcc could be distinguished from tfe3 rearranged rcc with panel results c and d, respectively Multilocular cystic renal neoplasm of low malignant potential Chromophobe renal cell carcinoma is the third most common rcc arising from the intercalated tubular cells.

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