病史：女，45岁，突发右腹痛1天

辅助检查：彩超：右肾局部低回声。请结合临床。

CT：右肾脏内富血供占位伴出血，恶性肿瘤，考虑肾癌伴出血。

ECT：双肾血流灌注和功能正常；右肾中-下部放射分布稀疏-缺损区。结合临床。

病理大体检查  右肾：大小12*6*4cm，带脂肪囊，切面距肾上级4.5cm，距肾下级3cm，肾门2cm，紧邻肾被膜处见一4*3*3cm的肿物，未穿透肾被膜，切面实性，中央出血暗红，周边灰白微黄、质软。

IHC：阳性：Vimentin，CD34，CD99，Ki67+/5%；

 阴性CK、EMA、Cam5.2，HMB45、MelanA，S100，SMA，ALK，CgA、CD56，CD20、CD3、CD21，Bcl-2。

错构瘤

 有无高血压、低血钾病史？IHC可以补CD117和肾素标记，和特染PAS，球旁细胞瘤要除外

把免疫组化的图片也传上来看看啊

 无高血压、低血钾病史，所以不符合球旁细胞瘤。

Juxtaglomerular cell tumor(JGCT) has clinically been proposed to be classified as typical, atypical, and nonfunctioning .Indeed, JGCT has been suggested to be considered in the diagnosis of any renal tumor featuring epithelial cells and negative cytokeratin immunostain. In this scenario, immunostains can aid in distinguishing JGCT from other mimickers, JGCT usually shows positive reaction to c-kit and CD34 in addition to rennin .