RESUMO
Background: Lymphoma is a malignant lymphoid tumor originating in the lymph nodes or other solid organs and comprises90% of all hematopoietic tumors in dogs. However, primary kidney lymphoma is rare and is associated with nonspecificclinical signs. Tumor invasion in both kidneys can cause severe clinical signs due to renal failure, complicating the patientstreatment and prognosis. The aim of this case was to report the case of a dog affected by bilateral primary kidney lymphoma. In addition, to characterize the clinical and histopathological presentation due to the intense morphological changes.Case: A 5-year-old male Poodle dog was admitted showing apathy and emesis for 5 days. On physical examination, thedog showed 10% of dehydration, reddish oral mucous membranes, poor body condition (score 1/5), uremic breath, andpain in the kidney area. Complementary tests revealed severe low white blood cells count, high BUN levels, high levels ofpotassium, calcium, and phosphorus (serum biochemistry). Abdominal ultrasound showed bilateral kidney enlargement.Fine needle aspiration of the mass (guided by ultrasound) revealed round cell tumor. Radiographs showed no alterations.The dog died due to his poor condition and necropsy was performed. On post-mortem examination, the kidneys were bothenlarged, pale, and with an irregular subcapsular surface. The histopathological diagnostic was primary renal lymphoma.Immunohistochemical staining revealed that neoplastic cells were strongly positive for anti CD20 and PAX5, while negative for CD3, supporting the diagnosis of B-cell lymphoma.Discussion: The diagnosis was based on clinical, complementary tests, fine needle aspiration, histopathological andimmunohistochemical findings. In dogs, primary kidney tumors are uncommon and usually malignant. The presence ofvomiting, uremic breath, dehydration, weight loss, and erosive and ulcerative lesions on the tongue (uremic glossitis)...(AU)
Assuntos
Animais , Masculino , Cães , Linfoma/diagnóstico por imagem , Linfoma/veterinária , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/veterinária , Uremia/veterinária , Transtornos Linfoproliferativos/veterináriaRESUMO
Background: Lymphoma is a malignant lymphoid tumor originating in the lymph nodes or other solid organs and comprises90% of all hematopoietic tumors in dogs. However, primary kidney lymphoma is rare and is associated with nonspecificclinical signs. Tumor invasion in both kidneys can cause severe clinical signs due to renal failure, complicating the patientstreatment and prognosis. The aim of this case was to report the case of a dog affected by bilateral primary kidney lymphoma. In addition, to characterize the clinical and histopathological presentation due to the intense morphological changes.Case: A 5-year-old male Poodle dog was admitted showing apathy and emesis for 5 days. On physical examination, thedog showed 10% of dehydration, reddish oral mucous membranes, poor body condition (score 1/5), uremic breath, andpain in the kidney area. Complementary tests revealed severe low white blood cells count, high BUN levels, high levels ofpotassium, calcium, and phosphorus (serum biochemistry). Abdominal ultrasound showed bilateral kidney enlargement.Fine needle aspiration of the mass (guided by ultrasound) revealed round cell tumor. Radiographs showed no alterations.The dog died due to his poor condition and necropsy was performed. On post-mortem examination, the kidneys were bothenlarged, pale, and with an irregular subcapsular surface. The histopathological diagnostic was primary renal lymphoma.Immunohistochemical staining revealed that neoplastic cells were strongly positive for anti CD20 and PAX5, while negative for CD3, supporting the diagnosis of B-cell lymphoma.Discussion: The diagnosis was based on clinical, complementary tests, fine needle aspiration, histopathological andimmunohistochemical findings. In dogs, primary kidney tumors are uncommon and usually malignant. The presence ofvomiting, uremic breath, dehydration, weight loss, and erosive and ulcerative lesions on the tongue (uremic glossitis)...
Assuntos
Masculino , Animais , Cães , Linfoma/diagnóstico por imagem , Linfoma/veterinária , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/veterinária , Uremia/veterinária , Transtornos Linfoproliferativos/veterináriaRESUMO
Metanephric adenoma (MA) is a rare benign neoplasm of the kidney that is usually asymptomatic and incidentally diagnosed. MA usually present as a solid mass; however, a cystic presentation has been reported. The main differential diagnosis of MA is the epithelial predominant Wilms tumor (e-WT) and the solid variant of papillary renal cell carcinoma (pRCC). The presence of the BRAF gene mutation has recently been reported in 85% of MA, and less than 10% of cases of MA do not express this specific gene mutation. Herein we report a 22-year-old man who presented with back pain and abdominal discomfort with a renal mass on the computed tomographic scan. The diagnosis of metanephric adenoma was confirmed histopathologically. In our case, the tumor presented as a solid and cystic mass hence mimicking a papillary renal cell carcinoma. The VE1 protein, which correlates with BRAF gene mutation, did not show any significant expression. We want to highlight that MA can present as a cystic lesion that should be taken into account to avoid unnecessary radical nephrectomy. Also, we demonstrated that a subset of MA might not harbor the BRAF gene and, they are classified as the BRAF wild type MA.
RESUMO
The ureteral avulsion during ureterolithotripsy (URS) occurs due to the sudden movement of the optical device or endoscopic extractor either in its removal or insertion, associated with a probable previous lesion in the ureter wall, causing a vital fragility area. A 52-year-old male patient with, an obstructive calculus of 9 mm was found in the left middle ureter, and a heterogeneous hypervascular nodule located in the right kidney, suggesting neoplasia. During procedure with rigid ureteroscopy with ureteroscope removal, due to the pressure of the device and tissue fragility, there was total ureter avulsion.
RESUMO
Metanephric adenoma (MA) is a rare benign neoplasm of the kidney that is usually asymptomatic and incidentally diagnosed. MA usually present as a solid mass; however, a cystic presentation has been reported. The main differential diagnosis of MA is the epithelial predominant Wilms tumor (e-WT) and the solid variant of papillary renal cell carcinoma (pRCC). The presence of the BRAF gene mutation has recently been reported in 85% of MA, and less than 10% of cases of MA do not express this specific gene mutation. Herein we report a 22-year-old man who presented with back pain and abdominal discomfort with a renal mass on the computed tomographic scan. The diagnosis of metanephric adenoma was confirmed histopathologically. In our case, the tumor presented as a solid and cystic mass hence mimicking a papillary renal cell carcinoma. The VE1 protein, which correlates with BRAF gene mutation, did not show any significant expression. We want to highlight that MA can present as a cystic lesion that should be taken into account to avoid unnecessary radical nephrectomy. Also, we demonstrated that a subset of MA might not harbor the BRAF gene and, they are classified as the BRAF wild type MA.
Assuntos
Humanos , Masculino , Adulto , Adenoma/patologia , Proteínas Proto-Oncogênicas B-raf , Neoplasias Renais/patologia , Tumor de Wilms , Diagnóstico Diferencial , NefrectomiaRESUMO
Pancreatic metastases are rare; they account for only 2% of all pancreatic malignancies and usually occur when associated with a disseminated metastatic disease. Solitary pancreatic metastases are even less frequent, and there are few reports regarding surgical resection. We report the case of a 77-year-old female patient diagnosed with a single cephalo-pancreatic metastasis of renal cell carcinoma, 16 years after a total nephrectomy. The patient underwent successful pancreaticoduodenectomy, and the diagnosis was confirmed. A subsequent positron emission tomography (PET) scan showed disease relapse, and tyrosine kinase inhibitor treatment with sunitinib was initiated. After 1 year and 4 months, the PET-computed tomography scan showed a complete radiologic response.
RESUMO
Pancreatic metastases are rare; they account for only 2% of all pancreatic malignancies and usually occur when associated with a disseminated metastatic disease. Solitary pancreatic metastases are even less frequent, and there are few reports regarding surgical resection. We report the case of a 77-year-old female patient diagnosed with a single cephalo-pancreatic metastasis of renal cell carcinoma, 16 years after a total nephrectomy. The patient underwent successful pancreaticoduodenectomy, and the diagnosis was confirmed. A subsequent positron emission tomography (PET) scan showed disease relapse, and tyrosine kinase inhibitor treatment with sunitinib was initiated. After 1 year and 4 months, the PET-computed tomography scan showed a complete radiologic response.
Assuntos
Humanos , Feminino , Idoso , Carcinoma , Metástase Neoplásica , Neoplasias Pancreáticas , Neoplasias Renais , Proteínas Tirosina Quinases/uso terapêuticoRESUMO
PURPOSE: We sought to identify racial differences among histological subtypes of renal cell carcinoma (RCC) between black and non-black patients in an equal-access health care system. MATERIALS AND METHODS: We established a multi-institutional, prospective database of patients undergoing partial or radical nephrectomy between January 1, 2000 and Sept 31, 2009. For the purposes of this study, data captured included age at diagnosis, race, tumor size, presence of lymphovascular invasion, presence of capsular invasion, margin status, and tumor histology. RESULTS: 204 kidney tumors were identified (Table-1). Of these, 117 (57.4 percent) were in black patients and 87 (42.6 percent) were in non-black patients. Age at surgery ranged from 37 to 87 with a median of 62. Tumor size ranged from 1.0 to 22.0 cm with a median of 5.0 cm. Overall, tumors were composed of clear cell RCC in 97 cases (47.5 percent), papillary RCC in 65 cases (31.9 percent), chromophobe RCC in 13 cases (6.4 percent), collecting duct/medullary RCC in 2 cases (1.0 percent), RCC with multiple histological subtypes in 8 cases (3.9 percent), malignant tumors of other origin in 6 cases (2.9 percent), and benign histology in 13 cases (6.4 percent). Among black patients, papillary RCC was seen in 56 cases (47.9 percent), compared to 9 cases (10.3 percent) among non-black patients (p < 0.001) (Table-2). Clear cell RCC was present in 38 (32.5 percent) of black patients and in 59 (67.8 percent) of non-blacks (p < 0.001). CONCLUSIONS: In our study, papillary RCC had a much higher occurrence among black patients compared to non-black patients. This is the first study to document such a great racial disparity among RCC subtypes.