VHL and von Hippel-Lindau disease: No specific genomic imbalances.Lacks genetic modifications of classic pRCC (no +7/+17 or -Y) and/or classic ccRCC (no -3/-3p).Activation of hypoxia inducible factor (HIF) pathway, with underexpressed VHL transcripts, but without typical VHL mechanism (no VHL gene mutations/promoter hypermethylation).May appear in VHL disease.