Figure 4.

Clear cell RCC component. A) The largest lesion described in the gross description was composed of cells with abundant clear cytoplasm and well-demarcated cellular borders. Marked oncocytic changes with a nodular configuration were present in some areas (H&E, 2×). B) The rectangle in A at higher magnification shows the transition between the clear (top) and oncocytic cells (bottom). Nuclear features in the clear cell areas were consistent with Furhman nuclear grade 2, whereas the oncocytic nodule's cells showed increased pleomorphism and slightly enlarged nucleoli (H&E, 10×). C) A separate area of the tumor showed clusters of tumor cells with marked nuclear pleomorphism, irregular nuclear contours, and prominent nucleoli, consistent with Furhman nuclear grade 3 (H&E, 40×).