A rare cause for a common symptom

Abstract

A rare cause for cough and fever http://ow.ly/d6zy301yYDJ.

Figure 1

Normal chest radiograph.

Figure 2

Ultrasound of the abdomen. a) Oblique axial image of the left kidney, showing an ill-defined heterogeneous hypoechogenic mass lesion, possibly arising from the upper and interpolar regions of the left kidney. b) Long-axis sagittal view of the left kidney, confirming the mass is located in the upper pole.

Figure 3

CECT of the abdomen, showing a) coronal view, arterial phase, and b) axial view at the upper lumbar level, T12 to L1 vertebral level.

Figure 4

CT of the thorax, showing a) lungs at T3 vertebral level, b) lungs at T7 vertebral level, and c) post-contrast mediastinal view at T7 vertebral level.

Figure 5

Gross specimen, showing a) the outer surface of the nephrectomy specimen with intact perinephric fat, and b) the cut surface of the left kidney, which shows an ill-defined tumour mass with a variegated appearance situated in the upper pole.

Figure 6

Haematoxylin and eosin stain at a) 100× and b) 400× magnification. Tumour cells are arranged in sheets and lobular pattern, with malignant clear cells diagnostic of RCC.