Clear cell renal cell carcinoma combined with intravascular large B-cell lymphoma: a case report and review of the literature

Figures

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  Figure 1. Abdominal contrast-enhanced CT scan of the kidney tumor and tumor macroscopy. An abdominal contrast-enhanced CT scan revealed a soft-tissue density protuberance with a diameter of approximately 28 mm in the left kidney (A, red arrow). In the arterial phase, the tumor exhibited slightly uneven enhancement, and the capsule was significantly enhanced (B, red arrow).

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  Figure 2. Histology of a representative image from the presented case. Hematoxylin and eosin (H&E) staining showed a tumor encapsulated by a thick fibrous capsule with distinct boundaries (A). Tumor cells exhibited abundant clear to eosinophilic cytoplasm and prominent basophilic nucleoli (B). Large and highly atypical lymphoid cells (C) were detected in the small- to medium-sized thin-walled vessels of clear cell renal cell carcinoma (ccRCC). These cells had irregular nuclear outlines, coarse chromatin, prominent single or multiple nucleoli, and scant to moderate cytoplasm (D). (The red arrows indicate the lymphoma component.).

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  Figure 3. Immunohistochemistry analysis. Immunohistochemistry (EnVision method) showed that ccRCC tumor cells displayed diffuse expression of PAX-8 (A), CA-IX (B), and CD10 (C). In contrast, the atypical lymphoid cells showed diffuse and strong positivity for CD20 (D) and PAX-8(A), while CD5 (E) showed only weak positivity. Staining of the vascular endothelium with CD34 clearly delineated the intravascular location of the atypical cells (F). (The red arrows indicate the lymphoma component.).