Raphael Vandana, Sailo Stephan, Bhuyan Ashim, Phukan Mandeep
Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.
Urol Ann. 2011 Sep;3(3):164-6. doi: 10.4103/0974-7796.84951.
Primary epithelial tumor of the renal pelvis is rare, and adenocarcinomas account for less than 1% of malignancies arising from the epithelium of the renal pelvis. We describe in this study a case of a 56-year old male patient who presented with an abdominal mass and dull aching pain for one year. A diagnosis of hydronephrosis of the right kidney was made based on imaging studies. Grossly, the entire kidney was converted into a cystic mass measuring 16 × 12 × 10 cm and filled with gelatinous material along with staghorn calculi in the pelvis measuring 7 × 4 × 3 cm. Histological examination of the tumor showed glands, cysts, and papillae lined by pseudostratified columnar epithelium with hyperchromatic nuclei. Scattered signet ring-type cells were also seen floating in large pools of extracellular mucin. Sections from the ureter showed a component of adenocarcinoma in situ. No invasive tumor was identified in ureteric tissue. Thus, a diagnosis of mucinous adenocarcinoma of the renal pelvis with in situ adenocarcinoma of the ureter was made.
肾盂原发性上皮性肿瘤较为罕见，腺癌在肾盂上皮来源的恶性肿瘤中所占比例不到1%。我们在本研究中描述了一例56岁男性患者，该患者出现腹部肿块和隐痛一年。根据影像学检查诊断为右肾积水。大体上，整个肾脏变成了一个大小为16×12×10 cm的囊性肿块，充满胶冻状物质，肾盂内还有一个大小为7×4×3 cm的鹿角形结石。肿瘤组织学检查显示腺体、囊肿和乳头，内衬假复层柱状上皮，细胞核染色质增多。还可见散在的印戒样细胞漂浮在大量细胞外黏液池中。输尿管切片显示原位腺癌成分。在输尿管组织中未发现浸润性肿瘤。因此，诊断为肾盂黏液腺癌伴输尿管原位腺癌。
