scholarly journals A Case with Significant Proteinuria Caused by Secreted Protein from Urothelial Carcinoma

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Masanori Sakakima ◽  
Yoshihide Fujigaki ◽  
Hideo Yasuda ◽  
Akashi Togawa ◽  
Tomoyuki Fujikura ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Renal Pelvis ◽  
Interstitial Fibrosis ◽  
Renal Tissue ◽  
Secreted Protein ◽  
Tubular Atrophy ◽  
Moderate Amount ◽  
Electron Dense Deposit ◽  
Unilateral Hydronephrosis ◽  
The Right

58-year-old female was admitted to our hospital complaining isolated proteinuria of 1.7 g/day. Abdominal echography showed right-sided unilateral hydronephrosis, and computed tomography pointed out a tumor of the right renal pelvis, suggesting cancer of renal pelvis. The right nephroureterectomy was carried out. Pathological diagnosis was urothelial carcinoma. Renal tissue revealed no apparent glomerulopathy with tubular atrophy, interstitial fibrosis, and mildly-to-moderately interstitial mononuclear cell infiltration. Immunofluorescence study showed no deposition of immunoreactanct, and electron microscopy showed almost normal glomerulus without electron dense deposit. Proteinuria disappeared within 6 days after the operation. Moderate amount of proteinuria in our patient was probably caused by secreted protein from urothelial carcinoma. This condition is rare but should be taken into account in patients with even moderate amount of proteinuria.

scholarly journals Biomarkers of Chronic Renal Tubulointerstitial Injury

2019 ◽  
Vol 67 (9) ◽  
pp. 633-641 ◽  
Author(s):  
Serena M. Bagnasco ◽  
Avi Z. Rosenberg
Keyword(s):  
Interstitial Fibrosis ◽  
Renal Tissue ◽  
Experimental Models ◽  
Renal Outcome ◽  
Tubulointerstitial Injury ◽  
Tubular Atrophy ◽  
Non Invasive ◽  
Diagnosis And Prognosis

Progression of renal parenchyma injury is characterized by increasing interstitial fibrosis and tubular atrophy, irrespective of the cause. Histopathologic assessment of renal tissue obtained by biopsy remains the gold standard for determining the presence and extent of tubulointerstitial scarring. Discovery of robust non-invasive means for capturing a snapshot and for longitudinal monitoring of parenchymal deterioration has been the focus of intense multimodal effort by investigators within the renal community and beyond. Research in this field has included the use of in vitro and in vivo experimental models and has fostered the development and evaluation of tissue and biofluid assays for novel analytes with potential translation to the diagnosis and prognosis of kidney disease. Here, we examine recent advances in the search of “biomarkers” for detection of renal tubulointerstitial scarring and prediction of renal outcome in human renal disease.

scholarly journals Lymphoepithelioma-like carcinoma of the renal pelvis: Pathological and therapeutic implications

2013 ◽  
Vol 7 (9-10) ◽  
pp. 590 ◽  
Author(s):  
Hemel Modi ◽  
Ian Beckley ◽  
Selina Bhattarai ◽  
John Spencer ◽  
Jon Cartledge
Keyword(s):  
Urothelial Carcinoma ◽  
Renal Pelvis ◽  
Histological Analysis ◽  
Pathological Features ◽  
Radical Nephroureterectomy ◽  
Therapeutic Implications ◽  
Lymphoid Stroma ◽  
Histological Appearance ◽  
The Right

A 75-year-old woman presented with a presumed urothelial carcinoma of the right renal pelvis. A radical nephroureterectomy was carried out and histological analysis of the specimen revealed lymphoepithelioma-like carcinoma. This is the seventh reported case of this normally nasopharyngeal tumour found in the renal pelvis. These tumours have a distinct histological appearance comprising sheets of undifferentiated syncytial cells on a background of lymphoid stroma. We review the pathological features of lymphoepithelioma-like carcinoma and make arguments for managing these tumours in a similar way to urothelial carcinoma.

scholarly journals Recurrent hydronephrosis and spontaneous renal rupture caused by lymphoplasmacytic inflammation in a cat

2021 ◽  
Vol 66 (No. 2) ◽  
pp. 80-86
Author(s):  
J Kim ◽  
D Oh ◽  
J Cho ◽  
S Kim ◽  
J Yoon
Keyword(s):  
Renal Pelvis ◽  
Abdominal Ultrasound ◽  
Crystallographic Analysis ◽  
Free Fluid ◽  
Moderate Amount ◽  
Immune Mediated ◽  
History Of ◽  
Urine Leakage ◽  
The Right ◽  
Renal Rupture

A seven-year-old male cat that was previously diagnosed with – and treated for – left hydronephrosis due to suspected idiopathic proteinaceous materials in the renal pelvis, presented with a short history of anorexia and vomiting. The abdominal ultrasound revealed bilateral hydronephrosis, and the intravenous pyelography showed a moderate amount of free fluid in the retroperitoneal space at 48 hours. After the nephrectomy, the gross examination of the right kidney revealed a very thin capsule with urine leakage, and the right renal pelvis showed small, black deposits. The histopathology of the right kidney revealed hydronephrosis with compression atrophy, necrosis of the renal cortex/medulla, and a moderate lymphoplasmacytic inflammation. The crystallographic analysis revealed that the black deposits were composed of 100% protein and no minerals. The cat was diagnosed with hydronephrosis and spontaneous renal rupture caused by proteinaceous pelvic materials, secondary to the idiopathic renal lymphoplasmacytic inflammation. In addition to revealing the possibility that immune-mediated renal disease can induce spontaneous renal rupture in cats, this case report demonstrates the utility of imaging for diagnosing and monitoring hydronephrosis, detecting urine leakage, and planning surgery.

scholarly journals Breast Angiosarcoma with a Preoperative Diagnosis of Late Recurrence of Breast Cancer: A Case Report

2021 ◽  
pp. 604-609
Author(s):  
Rika Kouhashi ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Tamami Morisaki ◽  
Sae Ishihara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Preoperative Diagnosis ◽  
Vascular Endothelial Cells ◽  
Interstitial Fibrosis ◽  
Late Recurrence ◽  
Breast Conserving Surgery ◽  
Surrounding Tissue ◽  
Axillary Lymph ◽  
Elevated Lesion ◽  
The Right

Angiosarcoma is a malignant mesenchymal tumor characterized by the presence of vascular endothelial cells. Although rare, angiosarcoma developing in the mammary glands has a poor prognosis. We report a case of breast angiosarcoma with a preoperative diagnosis of late recurrence of breast cancer. A 78-year-old woman noticed a tumor in her right breast and visited our hospital. The patient had undergone breast-conserving surgery and axillary lymph node dissection from the right breast 12 years before the visit. The tumor was diagnosed as T4bN0M0, stage IIIB. Anastrozole was administered as postoperative adjuvant therapy for 5 years; the patient also received 50-Gy whole-breast radiation therapy after surgery. Physical examination during her visit revealed an elevated lesion with blue purpura around the nipple in the right breast. We performed breast ultrasound and detected a well-defined 19.6 × 16.4 × 10.7 mm hypoechoic tumor in the left subareolar area. The patient underwent core needle biopsy (CNB). Based on the CNB specimen findings, she was suspected to experience late local recurrence after surgery. Therefore, she underwent total mastectomy after breast-conserving surgery. A dark-red tumor sized 18 × 12 mm was found in a specimen from the nipple. The pathological diagnosis of the specimen revealed short spindle-shaped tumor cells with strong nuclear pleomorphism and a significant interstitial fibrosis. Immunohistochemistry using D2-40 and CD31 antibodies showed irregular luminal proliferation at the anastomosis, infiltration into the surrounding tissue, and massive necrosis, thereby leading to the diagnosis of breast angiosarcoma. We have reported a case of breast angiosarcoma with a preoperative diagnosis of late recurrence of breast cancer.

Identifying patients with CKD risk at the time of nephrectomy: When to initiate nephrology consult

2021 ◽  
pp. 239936932110319
Author(s):  
Yihe Yang ◽  
Zachary Kozel ◽  
Purva Sharma ◽  
Oksana Yaskiv ◽  
Jose Torres ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Radical Nephrectomy ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Interstitial Fibrosis ◽  
Kidney Neoplasm ◽  
Tubular Atrophy ◽  
Independent Risk Factors

Introduction: The prevalence of chronic kidney disease (CKD) is high among kidney neoplasm patients because of the overlapping risk factors. Our purpose is to identify kidney cancer survivors with higher CKD risk. Methods: We studied a retrospective cohort of 361 kidney tumor patients with partial or radical nephrectomy. Linear mixed model was performed. Results: Of patients with follow-up >3 months, 84% were identified retrospectively to fulfill criteria for CKD diagnosis, although CKD was documented in only 15%. Urinalysis was performed in 205 (57%) patients at the time of nephrectomy. Multivariate analysis showed interstitial fibrosis and tubular atrophy (IFTA) >25% ( p = 0.005), severe arteriolar sclerosis ( p = 0.013), female gender ( p = 0.024), older age ( p = 0.012), BMI ⩾ 25 kg/m2 ( p < 0.001), documented CKD ( p < 0.001), baseline eGFR ⩽ 60 ml/min/1.73 m2 ( p < 0.001), and radical nephrectomy ( p < 0.001) were independent risk factors of lower eGFR at baseline and during follow-up. Average eGFR decreased within 3 months post nephrectomy. However, patients with different risk levels showed different eGFR time trend pattern at longer follow-ups. Multivariate analysis of time × risk factor interaction showed BMI, radical nephrectomy and baseline eGFR had time-dependent impact. BMI ⩾ 25 kg/m2 and radical nephrectomy were associated with steeper eGFR decrease slope. In baseline eGFR > 90 ml/min/1.73 m2 group, eGFR rebounded to pre-nephrectomy levels during extended follow-up. In partial nephrectomy patients with baseline eGFR ⩾ 90 ml/min/1.73 m2 ( n = 61), proteinuria ( p < 0.001) and BMI ( p < 0.001) were independent risk factors of decreased eGFR during follow up. Conclusions: As have been suggested by others and confirmed by our study, proteinuria and CKD are greatly under-recognized. Although self-evident as a minimum workup for nephrectomy patients to include SCr, eGFR, urinalysis, and proteinuria, the need for uniform applications of this practice should be reinforced. Non-neoplastic histology evaluation is valuable and should include an estimate of global sclerosis% (GS) and IFTA%. Patients with any proteinuria and/or eGFR ⩽ 60 at the time of nephrectomy or in follow-up with urologists, and/or >25% GS or IFTA, should be referred for early nephrology consultation.

scholarly journals Cellular Mechanisms of Tissue Fibrosis. 3. Novel mechanisms of kidney fibrosis

2013 ◽  
Vol 304 (7) ◽  
pp. C591-C603 ◽  
Author(s):  
Gabriela Campanholle ◽  
Giovanni Ligresti ◽  
Sina A. Gharib ◽  
Jeremy S. Duffield
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Interstitial Fibrosis ◽  
Kidney Injury ◽  
Innate Immune ◽  
Cellular Mechanisms ◽  
Tubular Atrophy ◽  
Kidney Fibrosis ◽  
Capillary Rarefaction ◽  
Peritubular Capillaries

Chronic kidney disease, defined as loss of kidney function for more than three months, is characterized pathologically by glomerulosclerosis, interstitial fibrosis, tubular atrophy, peritubular capillary rarefaction, and inflammation. Recent studies have identified a previously poorly appreciated, yet extensive population of mesenchymal cells, called either pericytes when attached to peritubular capillaries or resident fibroblasts when embedded in matrix, as the progenitors of scar-forming cells known as myofibroblasts. In response to sustained kidney injury, pericytes detach from the vasculature and differentiate into myofibroblasts, a process not only causing fibrosis, but also directly contributing to capillary rarefaction and inflammation. The interrelationship of these three detrimental processes makes myofibroblasts and their pericyte progenitors an attractive target in chronic kidney disease. In this review, we describe current understanding of the mechanisms of pericyte-to-myofibroblast differentiation during chronic kidney disease, draw parallels with disease processes in the glomerulus, and highlight promising new therapeutic strategies that target pericytes or myofibroblasts. In addition, we describe the critical paracrine roles of epithelial, endothelial, and innate immune cells in the fibrogenic process.

Intracranial Peripheral Primitive Neuroectodermal Tumors of the Cavernous Sinus: A Diagnostic Peculiarity

2005 ◽  
Vol 129 (1) ◽  
pp. e11-e15 ◽  
Author(s):  
Muhammad Idrees ◽  
Chirag Gandhi ◽  
Simone Betchen ◽  
James Strauchen ◽  
Wesley King ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Ewing Sarcoma ◽  
Moderate Amount ◽  
Primitive Neuroectodermal Tumors ◽  
Neuroectodermal Tumors ◽  
Male Preponderance ◽  
Poorly Differentiated ◽  
Immunohistochemical Techniques ◽  
The Right ◽  
Peripheral Primitive Neuroectodermal Tumors

Abstract Peripheral primitive neuroectodermal tumors (pPNETs) are aggressive, poorly differentiated neoplasms that occur in children and young adults. These tumors are associated with a peak incidence in the second decade and a slight male preponderance. Recently, Ewing sarcoma and pPNET tumors have been proven to carry identical translocations, the most common being t(11;22)(q24;q12). Intracranial Ewing sarcoma/pPNETs have rarely been described in the literature. We studied a case of intracranial pPNET arising in the right cavernous sinus of a 46-year-old man. On imaging, the tumor had both sellar and suprasellar components and was centered within the right parasellar region. Histologically, the tumor was composed of intermediate to large cells with round to oval hyperchromatic nuclei with distinct nucleoli. The cells contained a moderate amount of slightly basophilic cytoplasm. The tumor was markedly fibrotic and had collagen bands surrounding both individual and groups of cells. A large immunohistochemical panel was positive only for CD99 and vimentin. Fluorescence in situ hybridization did not show translocations associated with Ewing sarcoma/pPNET. However, a small percentage of these tumors can be negative for this translocation. In these cases, histology and immunohistochemical techniques in the absence of an alternative diagnosis are the only tools available to establish the diagnosis.

A case of sarcomatoid urothelial carcinoma of the right ureter

2021 ◽  
Vol 60 (6) ◽  
pp. 344-352
Author(s):  
Satomi HATTA ◽  
Kazumi FURUICHI ◽  
Masaki MORI ◽  
Natsumi YONEMOTO ◽  
Tomomi ITO ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
The Right

Microcystic Transitional Cell Carcinoma

2002 ◽  
Vol 126 (7) ◽  
pp. 859-861 ◽  
Author(s):  
Xavier Leroy ◽  
Emmanuelle Leteurtre ◽  
Alexandre De La Taille ◽  
David Augusto ◽  
Jacques Biserte ◽  
...  
Keyword(s):  
Transitional Cell Carcinoma ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Renal Pelvis ◽  
Transitional Cell ◽  
Macroscopic Hematuria ◽  
Computed Tomographic ◽  
First Case ◽  
History Of ◽  
Invasive Transitional Cell Carcinoma

Abstract Microcystic transitional cell carcinoma is a rare variant of urothelial carcinoma; to date, it has been described only in the urinary bladder. We report 2 cases of microcystic transitional cell carcinoma arising in the renal pelvis. The first case occurred in a 73-year-old man with a history of superficially invasive transitional cell carcinoma who presented with macroscopic hematuria and anemia. The second case occurred in a 62-year-old woman who had no relevant medical history and presented with hematuria. Computed tomographic scan revealed a tumor of the renal pelvis. In both cases, microscopic examination showed invasive transitional cell carcinoma with prominent cystic features. The cysts were irregular in size and were deeply infiltrative. The cysts were lined by single or multiple layers of cuboidal or flattened cells with minimal cytological atypia. The first patient died of his disease 18 months after presentation. The second patient remained well at her 6-month follow-up examination. Microcystic transitional cell carcinoma is an unusual, deceptively bland variant of urothelial carcinoma, which can mimic benign lesions.

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