cory Name: Nat M Stout | DOB: 3/13/1952 MRN: 00682516-6 | PCP: ANDREW G TRENELAY, MD PATHOLOGY SURGICAL PATHOLOGY FINAL REPORT - Details Images ‘Scan on 6/11/2021 10:55 AM Component Results Component Surgical Pathology Report Standard Range Your Value Your Value ‘40-SP-21-03913 Location: CHE-CAT The signing pathologist has (i) examined the relevant prepara the specimen(s) and rendered or confirmed the diagnosis(es). Surgical Pathology DIAGNOSIS. RIGHT KIDNEY, NEEDLE BIOPSY: CARCINOMA. SEE DISCUSSION. Electronically signed by: Fabian MD, Claire B Verified: 06/25/2021 8:30 Pathologist Performed at: Cheshire Med Ctr DHK Dept of Pathology, 580 Court Street, Keene, NH DISCUSSION The right kidney needle biopsy shows an infiltrating carcinoma characterized by ‘tubules and mild-to-moderate nuclear pleomorphism without significant nucleoli or ample cytoplasm. The tumor infiltrates within the normal cortical parenchyma with surrounding desmoplasia. ‘The immunohistochemical profile is characteristic of a primary GU carcinoma andComponent ‘Standard Range Your Value suspicious for a collecting duct carcinoma, although a urothelial carcinoma cannot be excluded. See consultation below. P athology Consult MAYO Laboratories, Rochester, MN. Interpretation FINAL DIAGNOSIS, Kidney, right, needle biopsy (40-SP-21 4°"03913; 06/10/2021): Infiltrating carcinoma. See Comment ‘COMMENT This carcinoma could not be further classified in the current needle biopsy. The differential diagnosis includes infiltrating urothelial carcinoma of the upper urinary tract, and collecting duct carcinoma. Ancillary Studies The carcinoma infiltrates renal parenchyma as single cells, cords, and tubules, These cells are positive for keratin 7, PAX8, and (focally) GATA3, and are negative for keratin 20, p63, p40, and TTF {immunohistochemical stain for p40 is performed on a provided unstained section from block Al at Mayo Clinic, and is reviewed in conjunction with the remaining immunostains performed at the referring institution). Report electronically signed by Aditya Raghunathan, M.D. Seen in consultation with Loren P. Herrera Hernandez, M.D A DDITIONAL STUDIES Immunohistochemistry Studies: Formalin-fixed, paraffin-embedded tissue sections are studied using the polymer technique with appropriate positive controls. These IHC studies provide the pathologist with adjunctive diagnostic information. Antibody specificity has been verified by testing antibodies on a series of in-house tissues with knownStandard Range Component Your Value immunohistochemical performance characteristics. The clinical interpretation of any antibody positive staining or its absence is evaluated within the context of clinical presentation, morphology, histopathological criteria and other diagnostic tests. Block Antibody Result (Positive/Negative) ACKT positive Ck20 negative TTFL negative PAX8 positive ADDITIONAL STUDIES GATA3 focal positive P63 negative ‘SPECIMEN( S) SUBMITTED A-RT kidney, biopsy (1) CLINICAL INFORMATION Right renal mass with bone lesions Report to: Michael Sarson SPECIMEN PROCESSING Received in formalin labeled right kidney is a skinny needle biopsy measuring 17 mm in length by less than 1 mm in e imeter. Entirely submitted in one block. General Information Ordered by JAMES M NICKERSON, MD Collected on 06/11/2021 10:55 AM Resulted on 06/25/2021 8:30 AM Result Status: Final result‘Component Your Value immunohistochemical performance characteristics. The clinical interpretation of any antibody positive staining or its absence is evaluated within the context of clinical presentation, morphology, histopathological criteria and other iagnostic tests. Block Antibody Result (Positive/Negative) ACKT positive CK20 negative ‘TTFL negative PAXS positive ADDITIONAL STUDIES GATA3 focal positive P63 negative SPECIMEN( S) SUBMITTED A-RT kidney, opsy (1) CLINICAL INFORMATION Right renal mass with bone lesions Report to: Michael Sarson SPECIMEN PROCESSING Received in formalin labeled right kidney is a skinny needle biopsy measuring 17 mm in length by less than 1 mm in diameter. Entirely submitted in one block. F General Information Ordered by JAMES M NICKERSON, MD Collected on 06/11/2021 10:55 AM Resulted on 06/25/2021 8:30 AM Result Status: Final result Standard Range