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. 2020 Mar 5;12(3):602. doi: 10.3390/cancers12030602

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© 2020 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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Acquired cystic disease-associated renal cell carcinoma (ACD-RCC). (A1–A3) In ACD-RCC, characteristic feature includes lace pattern (A1) with intratumoral oxalate crystals (A2) and coalescent vacuoles (A3). (B1–B3) Immunoprofiles of ACD-RCC. Similar to papillary renal cell carcinoma type II, ACD-RCC demonstrates high alpha-methylacyl-CoA racemase (AMACR; B1) and CD10 (B2) expression with cytokeratin 7 negativity (B3). Immunohistochemistry is needed to differentiate between tubulocystic carcinoma (TCC) and multilocular cystic renal neoplasms. TCC is partly cystic (C1) and partly tubular (C2), which is characteristically AMACR+ (C3) and carbonic anhydrase IX (CAIX)-negative (C4) tumor, whereas multilocular cystic RCC shows hemorrhage-filled cyst (D1) and heaped-up profiles of clear cells (D2), and inverse immunoprofiles to TCC, AMACR-negative (D3), and CAIX-positive (D4) findings. Scale bars = 1 mm.