Chin Sheray N, Foster Tanya, Char Gurendra, Garrison Audene
Department of Pathology, University Hospital of the West Indies, University of the West Indies, Mona, Kingston 7, Jamaica.
Department of Medicine, University Hospital of the West Indies, University of the West Indies, Mona, Kingston 7, Jamaica.
Case Rep Urol. 2014;2014:625153. doi: 10.1155/2014/625153. Epub 2014 Jul 14.
We report a case of coexisting urothelial cancer and renal tuberculosis in the same kidney. The patient is a 72-year-old female with a remote history of treated pulmonary tuberculosis who presented with haematuria, initial investigation of which elucidated no definitive cause. Almost 1 year later, a diagnosis of metastatic urinary tract cancer was made. The patient received chemotherapy for advanced collecting duct type renal cell carcinoma, based on histological features of renal biopsy. Subsequent confirmatory immunostains however led to a revised diagnosis of urothelial cancer, necessitating a change in chemotherapy regimen. A diagnosis of ipsilateral renal tuberculosis was made based on TB-PCR testing of renal biopsy tissue and anti-TB therapy was coadministered with chemotherapy. The patient died 9 months after diagnosis of metastatic urothelial cancer.
我们报告一例同一肾脏中同时存在尿路上皮癌和肾结核的病例。患者为一名72岁女性,有陈旧性肺结核治疗史,因血尿就诊,初步检查未明确病因。近1年后,诊断为转移性尿路癌。根据肾活检的组织学特征,患者接受了针对晚期集合管型肾细胞癌的化疗。然而,随后的确诊免疫组化导致尿路上皮癌的诊断修订,需要改变化疗方案。基于肾活检组织的结核聚合酶链反应(TB-PCR)检测诊断为同侧肾结核,并与化疗联合给予抗结核治疗。患者在转移性尿路上皮癌诊断9个月后死亡。