Primary Renal Synovial Sarcoma Presenting as Haemorrhagic Shock

Figures

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  Figure 1:. A CT scan of the abdomen and pelvis shows 10 × 11.2 × 18.7 cm right large subcapsular, perirenal and retroperitoneal haematoma compressing and exerting mass effect on the kidney with a cortical defect at the lower pole with adjacent 2 cm dense foci.

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  Figure 2:. MRI of the abdomen shows there is a completely exophytic 3.8 × 8.5 cm soft tissue mass arising from the right inferolateral renal cortex and confined to the perinephric space with new angiogenesis without sinus fat or collecting system invasion, and no regional lymph nodes or renal vein invasion. No intra-abdominal metastasis.

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  Figure 3:. The histopathology sections show an infiltrative spindle cell tumour with haemangiopericytoma-like blood vessels with little intervening stroma arranged in fascicular and storiform patterns. The cells are monotonous with scant amphophilic cytoplasm, ovoid to spindled vesicular nuclei with evenly dispersed chromatin and inconspicuous nuclei with mitotic rate of 3/HPF.

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  Figure 4:. The immunohistochemistry of the tumour tissue. (A) The positive reaction to CD99. (B) The positive reaction to pan-CK. (CD) The positive reaction to TLE-1.