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A subset of hemangioblastomas shows lobular clusters of tumor cells with less prominent cytoplasmic vacuolization. Such cases more closely resemble renal cell carcinoma. Immunohistochemistry can be used to work-up such cases, especially in the setting of von Hippel Lindau disease where both tumors may be seen. The stromal cells in hemangioblastomas are generally positive for inhibin and negative for cytokeratins, EMA, CD10, and pax-8. Renal cell carcinomas generally have the reverse profile.

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