Abstract
Fumarate hydratase deficient renal cell carcinoma is an exceptionally discerned neoplasm which arises on account of germline mutations within fumarate hydratase (FH) gene. Commonly, clinical manifestations as non-renal leiomyomatosis may concur. Neoplasm is associated with autosomal dominant mode of disease transmission. Neoplasm may configure as a high grade, infiltrative lesion comprised of papillary articulations or solid sheets of neoplastic cells. Characteristically, tumour cells nuclei are pervaded with inclusion-like nucleoli and demonstrate peri-nucleolar clearing. Neoplasm arises on account of oncogenesis triggered due to metabolic inconsistencies emerging as a consequence of defective fumarate hydratase enzyme. The high grade, infiltrative neoplasm articulating papillary structures or solid sheets is comprised of tumour cells incorporated with prominent cytomegalovirus (CMV)-like nucleolar inclusions and foci of peri-nucleolar clearing. Neoplastic cells manifest overexpression and immunoreactivity to modified cysteine (2SC) along with decimation of fumarate hydratase enzyme.
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