Journal of Pathology and Translational Medicine

Case Reports

Sarcomatoid Transitional Cell Carcinoma of the Renal Pelvis A report of two cases.: Kyo Young Lee, Mi seon Kwon, Yeong Jin Choi, Chang Suk Kang, Seok Jin Kang, Baying Kee Kim, Sang In Shim; Korean J Pathol. 1999;33(2):128-132.

Abstract: Sarcomatoid carcinomas are malignant epithelial neoplasms in which the tumor cells assume a partial or complete spindle cell pattern of growth, leading to the erroneous classification of some true carcinomas as sarcomas. These spindle cells are malignant and manifest various amount of both vimentin and cytokeratin. Positive reaction of some of the spindle cells for cytokeratin antibodies is confirmatory. Clinical features do not differ significantly from those of patients with high-grade transitional cell carcinoma. So far, 13 cases of sarcomatoid transitional cell carcinoma of the renal pelvis have been reported in English and Korean literature. In this report, we describe clinicopathologic features of recently observed two cases of sarcomatoid transitional cell carcinoma of the renal pelvis and summarize the pathologic findings of previously reported cases with review of the literature.

Epidermal Cyst in the Renal Pelvis: A Case Report with Review of the Literature.: Sun Zoo Kim, Tae In Park, Sang Han Lee, Jung Sik Kwak; Korean J Pathol. 2004;38(4):270-272.

Abstract PDF: We report here on a case of an epidermal cyst arising in the kidney. This cyst occurred in a 61-year-old woman with a past history of several attacks of ureteral stones and she received treatments of extracoporeal shock wave lithotripsy and open nephrolithostomy. On the intravenous pyelogram, a relatively well demarcated, 5x5 cm-sized lesion with calcification was detected in the renal pelvis and calices. The lesion was removed by percutaneous nephrolithotomy. Histologically, the lesion had the same morphologic feature as a typical epidermal cyst arising in the skin. It has been postulated that the intrarenal epidermal cyst arises either from epidermal remnants or it results from traumatic implantation of transformed epithelium. Considering the past history of the patient, it might well be suspected that the present case occurred as a result of traumatic implantation of metaplastic squamous epithelial cells. We report here on a very interesting case of an epidermal cyst in the renal pelvis with a review of the relevant literatures.

Localized Amyloidosis of the Ureter: A Report of Two Cases.: Ho Jung Lee, Dong Eun Song, Jong Eun Joo, Won Mi Lee, Dong Hoon Kim, Eun Kyung Kim, Jae Y Ro; Korean J Pathol. 2004;38(3):184-187.

Abstract PDF: We report on two cases of localized amyloidosis involving the ureter. The patients were a 64-year-old woman with right upper quadrant pain (case 1) and a 36-year-old woman suffering from left flank pain and intermittent gross hematuria (case 2). An intravenous pyelography of case 1 revealed multiple filling defects in the entire right ureter, whereas retrograde pyelography in case 2 showed diffuse narrowing in the mid and lower portions of the left ureter. Localized amyloidosis of the ureter was diagnosed in the two cases, and both had amyloid deposit in the renal pelvis and the urinary bladder in case 1, and in the contralateral ureter and the renal pelvis in case 2. Right nephroureterectomy was performed in case 1, but a segmental resection of the ureter with preservation of the kidney was administered in case 2. These two cases demonstrate that ureteral amyloidosis can be associated with amyloid deposition in the renal pelvis and the urinary bladder. Although ureteral amyloidosis is a rare occurrence, it should be considered in the differential diagnosis of ureteral obstruction to avoid unnecessary radical surgery.

Parapelvic Renal Cyst (Pericalyceal Lymphangiectasis): A case report.: Weon Seo Park, Je Geun Chi; Korean J Pathol. 1994;28(2):210-212.

Abstract PDF: Parapelvic renal cyst, also designated as pericalyceal lymphangiectasis, is an unusual lesion that is usually brought to light during surgery for ureteropelvic junction obstruction or recurrent pyelonephritis. Grossly, the renal pelvis is enveloped by a multilocular cystic mass filled with clear fluid. This lesion is confined to the peripelvic tissues and does not extend into the parenchyma, which, however, may show the effects of hydronephrosis or pyelonephritis. A 50-year-old man presented with hydronephrosis. An ultrasonography revealed hydronephro-sis of the left kidney. Intravenous pyelography and DMSA ("Tc-Dimercaptosuccinic acid) scan showed nonfunctioning kidney of the same side. Simple left nephrectomy was done. The renal pelvis was mildly dilated and a cyst was found buldging into the renal pelvis. The content was watery clear and the cyst was not connected to the renal pelvis or calyces. The cyst was round unilocular and lined by attenuated single layer of endothelial cells. The endothelial cells showed no reactivity to factor-VIII related antigen. With these findings, we concluded that this cystic lesion is basically lymphatic cyst and hydronephrosis was caused by the compression of pelvic out-flow of the kidney.

Original Article

Pseudosarcomatous Variant of Transitional Cell Carcinoma of the Renal Pelvis.: Yun Kyung Kang, Ta Jin Kim, Yong Il Kim, Si Whang Kim; Korean J Pathol. 1992;26(6):610-614.

Abstract PDF: We report a case of pseudosarcomatous variant of transitional cell carcinoma of the renal pelvis which showed grossly and microscopically the distinct biphasic growth patterns. Grossly, most part of the tumor showed solid growth protruding into the renal pelvic cavity as well as infiltrating into the parenchyma of lower pole. The overlying pelvic mucosa was replaced by a diffuse, papillary transitional cell carcinoma, and the solid mass was composed of pleomorphic spindle cell sarcomatoid component with frequent myxoid change and a few foci of osteoid deposit. Ultrastructural study of the spindle cells revealed epithelial differentiation featured with rich cytoplasmic organelles, basal lamina and basement membrane-like structures, although immunohistochemistry failed to detect epithelial differentiation.

Case Report

Keratinizing Desquamative Squamous Metaplasia of the Upper Urinary Tract: A case report.: Soo Min Kang, Sun Young Kim; Korean J Pathol. 1991;25(1):76-80.

Abstract PDF: Keratinizing desquamative squamous metaplasia of the transitional epithelium occurs rarely in the upper urinary tract, especially in the ureter. It is associated in most cases with long-standing chronic inflammation but the exact pathogenesis is unknown, and the relationship to cancer has continued to be controversial. More cases should be accumulated for a better assessmnt of this lesion. Recently, we experienced a case of keratinizing desquamative squamous metaplasia in the renal pelvis, adjacent calyces and ureter following acute and chronic pyelonephritis. Herein, we are presenting our case with a review of literatures.

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