Discovery Life Sciences 1236 Los Osos Valley Rd, Suite T, Los osos, CA 93402

www.DiscoveryLifeSciences.com Call: (805) 528-4341 Fax: (805) 534-1348

SURGICAL PATHOLOGY REPORT

De-Identi�ed Prodcut ID: DLS17-036415-01

SPECIMEN SUBMITTED:Part A: RIGHT KIDNEY

Part B: PARACAVAL ANDINTERAORTOCAVAL NODES

Patient Age/Sex 44 / M

Final Diagnosis

1. Right kidney, total nephrectomy (A) - Renal cell carcinoma, clear cell type (5 cm in greatestdimension), ISUP grade 3 of 4. See synoptic report.- Tumor is con�ned to the kidney.- Lymphovascular invasion is not identi�ed.- Ureteral, vascular and soft tissue margins of resection are negative for tumor.

2. Lymph nodes paracaval and interaortocaval, excision (B) - Two lymph nodes negative for tumor(0/2).

Intraoperative Diagnosis:{Not Entered}

Clinical Diagnosis:RIGHT RENAL MASS

SURGICAL PATHOLOGY REPORT

Discovery Life Sciences 1236 Los Osos Valley Rd, Suite T, Los osos, CA 93402

www.DiscoveryLifeSciences.com Call: (805) 528-4341 Fax: (805) 534-1348

Gross Description:A. Received in formalin labeled "right kidney" is a right kidney surrounded by an envelope of�broadipose tissue measuring 24.0 x 14.0 x 9.2 cm and weighing 1054.0 grams. The soft tissue line ofresection is inked black. The kidney measures 12.5 x 7.0 x 6.0 cm. A 5.0 x 4.7 x 4.2 cm mass involvesthe midportion of the kidney. On section, the mass is roughly spherical, yellow-orange with areas ofhemorrhage. The mass bulges into the perirenal fat but not extend into or through the capsule or involvethe perirenal fat. The mass is within 0.1 cm of the soft tissue line of the specimen. The mass does notinvade the renal sinus. The mass is sharply demarcated from the renal parenchyma, which appearsessentially unremarkable. Satellite nodules are not present. Dissection of the renal veins, particularlythose draining the area of the mass, does not show the intravascular presence of a neoplasm. Theadrenal gland is not present. A 9.0 cm segment of ureter is present and is essentially unremarkable.Two nodules resembling lymph nodes are identi�ed at the hilum. Representative sections are submittedas follows: A1 Vascular margin; A2 Ureteral margin; A3-A5 Mass with inked soft tissue line of resection;A6-A7 Mass with renal sinus and pelvis; A8 additional representative section of mass; A9 representativesection of uninvolved kidney parenchyma; A10 hilar nodules, totally submitted.

B. Received fresh labeled "paracaval and interaortocaval nodes" are multiple yellow-pink segments of�brofatty tissue aggregating to 6.0 x 4.9 x 2.0 cm. Upon palpation, nine nodules are identi�ed ranging insize from 0.6 to 3.1 cm in greatest dimension. The nodules are totally submitted as follows: B1 threenodules, B2 two nodules, B3 two nodules, B4 one nodule sectioned and totally submitted, B5-B7 onenodule sectioned and totally submitted.

Microscopic:{Not Entered}

Discovery Life Sciences 1236 Los Osos Valley Rd, Suite T, Los osos, CA 93402

www.DiscoveryLifeSciences.com Call: (805) 528-4341 Fax: (805) 534-1348

SURGICAL PATHOLOGY REPORT

Synoptic Data:RIGHT KIDNEY: KIDNEY:NEPHRECTOMYSpecimen Site: Kidney structureProcedure: Total nephrectomy without adrenal glandSpecimen Laterality: RightTumor Site: MiddleTumor Focality: UnifocalMacroscopic Extent of Tumor: Tumor limited to kidneyHistologic Type: Clear cell renal cell carcinomaSarcomatoid Features: Not identi�edRhabdoid Features: Not identi�edHistologic Grade (ISUP Nucleolar Grade): ISUP grade 3: nucleoli should be distinctly visible at x100 magni�cationTumor Size: Greatest dimension: 5 cmMicroscopic Tumor Extension: Tumor limited to kidneyMargin Status: Margins uninvolved by invasive carcinomaTumor Necrosis: Not identi�edLymph-Vascular Invasion: Not identi�edTNM Descriptors: Not applicablePrimary Tumor (pT): pT1b: Tumor more than 4 cm but not more than 7 cm in greatest dimension, limited to the kidneyRegional Lymph Nodes (pN): pN0: No regional lymph node metastasis Number of regional lymph nodes examined: 2 Number of regional lymph nodes positive: 0Distant Metastasis (pM): Not applicablePathologic Findings in Nonneoplastic Kidney: Glomerular disease: Focal glomerularsclerosisRepresentative Tumor Block: Specify: A4, A6--------------------------------------------------------