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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 2379 - 8 August 2019 Posted By: Arti Bakshi

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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37 year old male – right axillary lymph node biopsy.Previous history of partial nephrectomy (left kidney) for clear cell renal cell carcinoma. Also history of benign adnexal tumour excised from axilla, 3 years back.


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Krishnakumar subramanian

Posted

IHC data on CAIX and CK 7 needed with a history of Clear cell RCC

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At first glance, it seems obviously a metastatic clear cell renal cell carcinoma. The clinical history and the histological pictures are pretty suggestive of RCC metastasis. But there is a history of a benign adnexial tumor in the axilla 3 years ago. Looking closer, we do not see the classical vasculature of RCC. There are reports of a rare nodal clear cell hidradenoma wich could be primary nodal or secondary to a "benign" metastasis. IHQ with PAX-8, RCC, p63 and keratin 5/6 could help in this differentiation.

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Meenakshi Batrani

Posted

4 hours ago, IgorSC said:

At first glance, it seems obviously a metastatic clear cell renal cell carcinoma. The clinical history and the histological pictures are pretty suggestive of RCC metastasis. But there is a history of a benign adnexial tumor in the axilla 3 years ago. Looking closer, we do not see the classical vasculature of RCC. There are reports of a rare nodal clear cell hidradenoma wich could be primary nodal or secondary to a "benign" metastasis. IHQ with PAX-8, RCC, p63 and keratin 5/6 could help in this differentiation.

Agree. Lymph node involvement by clear cell nodular hidradenoma is known. In last image, there appears to be a cystic/duct like structure with apocrine type lining. IHC needed to differentiate from RCC. 

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Agree with above.  There aren’t erythrocytes between clear cell nests and there is an obvious apocrine cystic change in last fig.  Thinking of a Low grade hydradenocarcinoma.  

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Dr. Richard Carr

Posted

Agree looks like hidradenoma in a LN.

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