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(A) Gross examination of the radical nephrectomy showing a large tumor, diffusely infiltrative in the renal parenchyma; (B) Immunohistochemistry showing strong and diffuse nuclear positivity for TFE3; (C) TFE3 rearranged carcinoma with papillary and alveolar growth pattern, composed of clear to eosinophilic discohesive pseudostratified cells with voluminous cytoplasm and high grade nuclei; (D) Neoplastic vascular invasion, an histological sign of aggressive behavior.
