倾向于肾细胞癌

 不知可否考虑球旁细胞瘤？不知临床情况如何，比如血压、血钾等。

 肾细胞癌

 

 I would make a guess for the diagnosis...papillary renal cell carcinoma for two reasons: 1) focal papillary configuration in fig. 1; 2) presence of foamy macrophages in the stroma in last figure, which can be a subtle feature for papillary RCC. Look fowarding to hearing the final answer.  Thanks.  

 期待结果

 球旁细胞瘤也可有乳头形成，那些细胞呈上皮样，与PRCC的形态似乎不符。那些泡沫状细胞是否是组织细胞？原单位的IHC结果如何？临床是否有高血压？ 期待结果。

 球旁细胞瘤

 I like the idea of 球旁细胞瘤. But is so rare, I have only seen one case before...It looks like a low grade vascular tumor.

 图1肿瘤呈乳头状结构排列，轴心可见泡沫样巨噬细胞，考虑乳头状肾细胞癌。球旁细胞瘤形成的乳头状结构轴心应是什么成分呢？没见过。免疫组化可做CK7、renin、vim、actin、CD34