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

Figure 5.

Figure 5

Microphthalmos translocation family RCC (MiT RCC). (A1–A4) In MiT RCC, characteristic findings include intracystic papillary masses composed of clear cells (A2) with psammoma bodies (A1) and fibrins (A3) and sometimes marked reverse polarity (A4). However, these findings are not specific to diagnose MiT RCC by histology alone. (B,C) When MiT RCC is suspected, adequate immunohistochemical panel should be applied, beginning with cathepsin K staining (C1). Conventional markers such as CK7 (not shown), epithelial membrane antigen (B1), alpha-methylacyl-CoA racemase (B2), and carbonic anhydrase IX (not shown) are generally negative, while HMB45 (B3) and melan A (B4) are occasionally positive. A more definitive diagnosis can be made with transcription factor E3 (C2) or fluorescent in situ hybridization break-apart signals (C3). (D1–D5) The characteristic findings transcription factor EB (TFEB)-related MiT RCC include nested fluoret sign (D1,D2), ballooning clear cells (D3), stromal hyalinization, fibrinous occlusive blood vessels with extensive peliosis-like changes (D4), and melanin pigment deposit in tumor cells (D5). (E1–E4) Immunohistochemical profiles. TFEB (E1,E2), cathepsin K (E3), HMB45 (E4), paired box gene 8 (E5) are specifically positive. Scale bars = 1 mm.