原发性肾实质鳞状细胞癌模拟脓肿:经尿路细针抽吸在术前评估中的价值:1例报告及文献复习。

IF 1.1 4区 医学 Q3 PATHOLOGY
Yusuke Ono, Masaki Murata, Akira Takasawa, Rena Morita, Makoto Osanai
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引用次数: 0

摘要

原发性肾实质鳞状细胞癌(SCC)是非常罕见的,只有7例报告至今。我们报告一个72岁的女性复发性膀胱炎,肉眼血尿,和右肾肿块。影像学检查显示肾实质坏死病变,最初提示脓肿。尽管经皮引流和抗生素治疗,没有临床改善。经尿路细针穿刺(FNA)提供了恶性肿瘤的术前细胞学证据,其特征与SCC一致,肾切除术标本的组织病理学检查,在免疫组织化学的支持下,证实原发性肾实质SCC。患者随后接受根治性肾切除术,组织病理学检查证实原发性肾实质鳞状细胞癌,未累及肾盆腔。尽管及时进行了手术治疗,但在几个月内发现转移扩散到淋巴结、椎骨和肺部,患者在术后18个月死亡。本病例强调了在鉴别诊断脓肿样肾脏病变时考虑SCC的重要性,特别是当它们对抗生素没有反应时。在选定的患者中,经尿路FNA提供了一种快速、微创的方法来获取细胞学材料,这可以防止延误并促进及时管理,潜在地改善类似挑战性病例的预后。进一步的研究将阐明诊断和治疗策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Primary renal parenchymal squamous cell carcinoma mimicking abscess: value of trans-urinary tract fine-needle aspiration in preoperative evaluation: a case report and literature review.

Primary squamous cell carcinoma (SCC) of the renal parenchyma is exceedingly rare, with only seven cases reported to date. We report a 72-year-old woman with recurrent cystitis, gross hematuria, and a right renal mass. Imaging studies revealed a necrotic lesion in the renal parenchyma, initially suggestive of an abscess. Despite percutaneous drainage and antibiotic therapy, there was no clinical improvement. Trans-urinary tract fine-needle aspiration (FNA) provided preoperative cytologic evidence of malignancy with features consistent with SCC, and histopathologic examination of the nephrectomy specimen, supported by immunohistochemistry, confirmed primary renal parenchymal SCC. The patient subsequently underwent radical nephrectomy, and histopathological examination confirmed a primary SCC of the renal parenchyma without renal pelvic involvement. Although surgical treatment was performed promptly, metastatic spread to lymph nodes, vertebrae, and lungs was detected within months, and the patient died 18 months postoperatively. This case highlights the importance of considering SCC in the differential diagnosis of abscess-like renal lesions, particularly when they fail to respond to antibiotics. In selected patients, trans-urinary tract FNA offers a rapid, minimally invasive means to obtain cytologic material, which can prevent delays and facilitate timely management, potentially improving outcomes in similarly challenging cases. Additional studies will clarify diagnostic and therapeutic strategies.

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来源期刊
Medical Molecular Morphology
Medical Molecular Morphology 医学-病理学
CiteScore
2.90
自引率
5.60%
发文量
30
审稿时长
>12 weeks
期刊介绍: Medical Molecular Morphology is an international forum for researchers in both basic and clinical medicine to present and discuss new research on the structural mechanisms and the processes of health and disease at the molecular level. The structures of molecules, organelles, cells, tissues, and organs determine their normal function. Disease is thus best understood in terms of structural changes in these different levels of biological organization, especially in molecules and molecular interactions as well as the cellular localization of chemical components. Medical Molecular Morphology welcomes articles on basic or clinical research in the fields of cell biology, molecular biology, and medical, veterinary, and dental sciences using techniques for structural research such as electron microscopy, confocal laser scanning microscopy, enzyme histochemistry, immunohistochemistry, radioautography, X-ray microanalysis, and in situ hybridization. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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