Duodenal subepithelial hyperechoic lesions of the third layer: Not always a lipoma

Figure 1 Endoscopic ultrasonography and cytology findings of a renal cell carcinoma metastasis. A: Hyperechoic mass in the duodenal bulb, apparently originating from the third layer. Adjacent, a small lymph node is noted; B-E: Fine-needle aspiration cell blocks, × 400 magnification; Hematoxylin and eosin staining showing clear cell aggregates (B). Positive immunostaining for cytokeratin AE1/AE3 (C), vimentin (D) and CD10 (E): consistent with an epithelial carcinoma of renal origin.