Figure 2

Morphologic spectrum of TFEB-amplified renal cell carcinoma, including (a, b) high-grade oncocytic and papillary morphology with foci of orderly polarization of nuclei in the mid to apical aspect of oncocytic cells (Case 6), H&E, × 200 (inset of a: TFEB FISH demonstrating amplification). Immunohistochemical work-up demonstrated patchy Melan-A expression (inset of b, × 100). Two other high-grade tumors with papillary and oncocytic features including orderly polarization of nuclei in the mid to apical aspect of oncocytic cells are depicted in (c) H&E from Case 5, × 200, and (d) H&E from Case 1, × 200. Case 1 also demonstrated areas of dyscohesion and cells with cytoplasmic vacuoles (e, H&E, × 200; inset: H&E, × 200), as well as focal areas of smaller cells forming acinar structures (f, H&E, × 400).