Figure 3Figure 3
Suggested diagnostic workflow for suspected MiT family renal cell carcinoma (MiT-RCC). The algorithm integrates clinical-pathologic suspicion, confirmation of renal origin, an immunohistochemistry (IHC) screening panel ( TFE3 , TFEB , and GPNMB), confirmatory break-apart fluorescence in situ hybridization (FISH) for rearrangements where appropriate, and advanced molecular testing (RNA-based fusion assays, TRIM63 RNA in situ hybridization (RNA-ISH), and copy-number assessment for TFEB / VEGFA amplification) in equivocal cases. Abbreviations: EMA, epithelial membrane antigen; FISH, fluorescence in situ hybridization; GPNMB, glycoprotein NMB; IHC, immunohistochemistry; panCK, pancytokeratin; PAX2, paired box gene 2; PAX8, paired box gene 8; PEComa, perivascular epithelioid cell neoplasm; RNA-ISH, RNA in situ hybridization; RT-PCR, reverse transcription polymerase chain reaction; SMA, smooth muscle actin; S100, S100 protein; SOX10, SRY-box transcription factor 10; VEGFA , vascular en