Volume 74, Issue 4, Pages (October 2018)

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Volume 74, Issue 4, Pages 483-486 (October 2018) Somatic Bi-allelic Loss of TSC Genes in Eosinophilic Solid and Cystic Renal Cell Carcinoma  Rohit Mehra, Pankaj Vats, Xuhong Cao, Fengyun Su, Nicole D. Lee, Robert Lonigro, Kumpati Premkumar, Kiril Trpkov, Jesse K. McKenney, Saravana M. Dhanasekaran, Arul M. Chinnaiyan  European Urology  Volume 74, Issue 4, Pages 483-486 (October 2018) DOI: 10.1016/j.eururo.2018.06.007 Copyright © 2018 European Association of Urology Terms and Conditions

Fig. 1 Somatic bi-allelic loss of tuberous sclerosis complex (TSC) genes in eosinophilic solid and cystic renal cell carcinoma (ESC RCC). (A) Low (top) and high (middle) magnification of the histology images of a representative ESC RCC case with solid and cystic growth pattern and cells with abundant eosinophilic cytoplasm; high (bottom) magnification of a TSC RCC case with similar morphology to ESC RCC. Scale bars low: 1mm and high: 100μm. (B) Schematic representation of TSC1 protein domains with the observed mutational events in ESC RCC (top) and copy number loss of heterozygosity (LOH) plots for chromosomes 8, 9, and 10 (bottom). TSC1 is located on chromosome 9 in the human genome. (C) Schematic representation of TSC2 protein functional domains with the observed mutational events in ESC RCC (top) and copy number LOH plots for chromosomes 15, 16, and 17 (bottom). TSC2 is located on chromosome 16 in the human genome. Deleterious somatic mutations, including frameshift indels (orange), nonsense (deep red), and splice site (blue) events in TSC genes are depicted. Copy number plots green: LOH; red: gain; black: diploid. (D) Table summarizes the mutually exclusive TSC gene aberrations in ESC RCC samples. (E) Flow chart indicates the type of TSC aberrations that characterizes and distinguishes TSC RCC from ESC. European Urology 2018 74, 483-486DOI: (10.1016/j.eururo.2018.06.007) Copyright © 2018 European Association of Urology Terms and Conditions

Fig. 2 Bi-allelic loss of tuberous sclerosis complex genes activates mammalian target of rapamycin pathway in eosinophilic solid and cystic renal cell carcinoma (ESC RCC). (A) Hematoxylin and eosin stained section from ESC RCC showing characteristic morphological features (red star) and background benign renal parenchyma (green star). Scale bar: 200μm. (B) Tumor cells diffusely and moderately express phospho-4E-BP1 (red star) with negative expression in the background renal parenchyma (green star). Scale bar: 200μm. (C) Tumor cells diffusely and strongly express phospho-S6 Rib P D68.F8 (red star) with weak expression in certain cell types in the background renal parenchyma (green star). Scale bar: 200μm. (D) Tumor cells diffusely and strongly express phospho-S6 Rib P D57.2.2E (red star) with weak to moderate expression in certain cell types within the background renal parenchyma (green star). Scale bar: 200μm. European Urology 2018 74, 483-486DOI: (10.1016/j.eururo.2018.06.007) Copyright © 2018 European Association of Urology Terms and Conditions