Diagnosis/dDx

Diagnosis required nephrectomy as imaging findings are not specific. 

Diagnosis: Chromophobe RCC confined to the kidney, no lymphovascular invasion, necrosis or sarcomatoid degeneration. 

Differential diagnosis: Oncocytoma, clear cell RCC 

This is not a lipid-poor AML, as these are often higher attenuation than renal parenchyma and are consistently T2 hypointense relative to renal parenchyma.