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  Indian J Med Microbiol
 

Figure 3: Entities comprising the differential diagnosis of HLRCC-associated renal cell carcinoma. (a) Type 2 papillary renal cell carcinoma with tumoral papillae lined by pseudostratified epithelial cells with eosinophilic cytoplasm and prominent nuclei raising a differential diagnosis of HLRCC-associated renal cell carcinoma (×100); (b) Collecting duct carcinoma exhibiting prominent glandular differentiation, desmoplastic stromal response, and tumor cells containing uniformly prominent macronucleoli resembling those seen in HLRCC-associated renal cell carcinoma (×200). Fumarate hydratase immunostaining (not shown) was retained in this case, militating against HLRCC-associated RC; (c) Clear cell renal cell carcinoma with a pseudopapillary growth pattern and eosinophilic cytoplasm can also mimic HLRCC-associated renal cell carcinoma. The racemase vascular network in the background is also helpful in making a correct diagnosis (×200); (d) Tubulocystic carcinoma showing a well-circumscribed cystic tumor composed of tubules (×100); (e) Cystic spaces in tubulocystic carcinoma lined by cuboidal cells with prominent macronucleoli rising a diagnostic consideration of HLRCC-associated renal cell carcinoma, particularly in biopsy specimens (×200); (f) TFE3 translocation renal cell carcinoma with a papillary growth pattern and dual eosinophilic and clear cytoplasm shows some overlapping features with HLRCC-associated renal cell carcinoma (×100); (g) TFEB-amplified renal cell carcinoma with an oncocytic phenotype and broadly anastomosing papillae is another tumor in the differential diagnosis distinguished by expression of melanocytic markers and fluorescence in situ hybridization testing (×100); (h) SDH-deficient renal cell carcinoma demonstrating cells with uniform nuclei, fine-stippled chromatin, flocculent eosinophilic cytoplasm, and occasional inclusions is included in the differential diagnosis for the low-grade, oncocytic variant of HLRCC-associated renal cell carcinoma (×100) (all images - hematoxylin and eosin staining)

Figure 3: Entities comprising the differential diagnosis of HLRCC-associated renal cell carcinoma. (a) Type 2 papillary renal cell carcinoma with tumoral papillae lined by pseudostratified epithelial cells with eosinophilic cytoplasm and prominent nuclei raising a differential diagnosis of HLRCC-associated renal cell carcinoma (×100); (b) Collecting duct carcinoma exhibiting prominent glandular differentiation, desmoplastic stromal response, and tumor cells containing uniformly prominent macronucleoli resembling those seen in HLRCC-associated renal cell carcinoma (×200). Fumarate hydratase immunostaining (not shown) was retained in this case, militating against HLRCC-associated RC; (c) Clear cell renal cell carcinoma with a pseudopapillary growth pattern and eosinophilic cytoplasm can also mimic HLRCC-associated renal cell carcinoma. The racemase vascular network in the background is also helpful in making a correct diagnosis (×200); (d) Tubulocystic carcinoma showing a well-circumscribed cystic tumor composed of tubules (×100); (e) Cystic spaces in tubulocystic carcinoma lined by cuboidal cells with prominent macronucleoli rising a diagnostic consideration of HLRCC-associated renal cell carcinoma, particularly in biopsy specimens (×200); (f) TFE3 translocation renal cell carcinoma with a papillary growth pattern and dual eosinophilic and clear cytoplasm shows some overlapping features with HLRCC-associated renal cell carcinoma (×100); (g) TFEB-amplified renal cell carcinoma with an oncocytic phenotype and broadly anastomosing papillae is another tumor in the differential diagnosis distinguished by expression of melanocytic markers and fluorescence<b> in situ</b> hybridization testing (×100); (h) SDH-deficient renal cell carcinoma demonstrating cells with uniform nuclei, fine-stippled chromatin, flocculent eosinophilic cytoplasm, and occasional inclusions is included in the differential diagnosis for the low-grade, oncocytic variant of HLRCC-associated renal cell carcinoma (×100) (all images - hematoxylin and eosin staining)