肾切除术中的常规、乳头状肾细胞癌和局灶节段性肾小球硬化

IF 0.2
Firas Al-Delfi, G. Herrera
{"title":"肾切除术中的常规、乳头状肾细胞癌和局灶节段性肾小球硬化","authors":"Firas Al-Delfi, G. Herrera","doi":"10.1097/PCR.0000000000000121","DOIUrl":null,"url":null,"abstract":"This is a case report of a 63-year-old morbidly obese (body mass index, 46.5 kg/m2) African American woman with a medical history of recurrent urinary tract infections, diverticulosis/diverticulitis, duodenitis, colovesical fistula, gout, hypertension, degenerative joint disease, carpal tunnel syndrome, a 20-pack-year history of tobacco use, and bilateral axillary hidradenitis suppurativa. After multiple episodes of gross hematuria and suprapubic discomfort, a computed tomographic scan showed a solid mass in the lower pole of the right kidney. The patient underwent right open radical nephrectomy in May 2010 without major complications. A conventional (clear cell) renal cell carcinoma and a small papillary renal cell carcinoma were found upon histopathologic examination of the kidney. Examination of the nonneoplastic renal parenchyma revealed changes indicative of focal segmental glomerulosclerosis, as well as mild arterial nephrosclerosis. No tumor metastases were detected at 5 years after nephrectomy. Her serum creatinine and estimated glomerular filtration rate gradually deteriorated in the 5 years after nephrectomy. The gradual, less steep renal function deterioration of this patient emphasizes the importance of reporting nonneoplastic renal lesions/diseases in nephrectomies for kidney and renal pelvis tumors. She developed edema, progressive proteinuria reaching 6.5 g/d, and serum creatinine level of 4.2 mg/dL (baseline serum creatinine at time of nephrectomy was 0.7 mg/dL). The early diagnosis helped medically manage and delay the progression of the medical renal disorder. An easy algorithmic approach for nonneoplastic renal parenchymal tissue should be adopted by general/surgical pathologists when evaluating surgical nephrectomies.","PeriodicalId":43475,"journal":{"name":"AJSP-Reviews and Reports","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/PCR.0000000000000121","citationCount":"1","resultStr":"{\"title\":\"Conventional and Papillary Renal Cell Carcinomas and Focal Segmental Glomerulosclerosis in a Nephrectomy\",\"authors\":\"Firas Al-Delfi, G. Herrera\",\"doi\":\"10.1097/PCR.0000000000000121\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"This is a case report of a 63-year-old morbidly obese (body mass index, 46.5 kg/m2) African American woman with a medical history of recurrent urinary tract infections, diverticulosis/diverticulitis, duodenitis, colovesical fistula, gout, hypertension, degenerative joint disease, carpal tunnel syndrome, a 20-pack-year history of tobacco use, and bilateral axillary hidradenitis suppurativa. After multiple episodes of gross hematuria and suprapubic discomfort, a computed tomographic scan showed a solid mass in the lower pole of the right kidney. The patient underwent right open radical nephrectomy in May 2010 without major complications. A conventional (clear cell) renal cell carcinoma and a small papillary renal cell carcinoma were found upon histopathologic examination of the kidney. Examination of the nonneoplastic renal parenchyma revealed changes indicative of focal segmental glomerulosclerosis, as well as mild arterial nephrosclerosis. No tumor metastases were detected at 5 years after nephrectomy. Her serum creatinine and estimated glomerular filtration rate gradually deteriorated in the 5 years after nephrectomy. The gradual, less steep renal function deterioration of this patient emphasizes the importance of reporting nonneoplastic renal lesions/diseases in nephrectomies for kidney and renal pelvis tumors. She developed edema, progressive proteinuria reaching 6.5 g/d, and serum creatinine level of 4.2 mg/dL (baseline serum creatinine at time of nephrectomy was 0.7 mg/dL). The early diagnosis helped medically manage and delay the progression of the medical renal disorder. An easy algorithmic approach for nonneoplastic renal parenchymal tissue should be adopted by general/surgical pathologists when evaluating surgical nephrectomies.\",\"PeriodicalId\":43475,\"journal\":{\"name\":\"AJSP-Reviews and Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2015-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1097/PCR.0000000000000121\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AJSP-Reviews and Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/PCR.0000000000000121\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AJSP-Reviews and Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/PCR.0000000000000121","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1

摘要

本文报告一例63岁的病态肥胖(体重指数46.5 kg/m2)非裔美国女性,既往有反复尿路感染、憩室病/憩室炎、十二指肠炎、膀胱瘘、痛风、高血压、退行性关节疾病、腕管综合征、20年吸烟史和双侧腋窝化脓性汗腺炎病史。在多次出现肉眼血尿和耻骨上不适后,计算机断层扫描显示右肾下极有一个实性肿块。患者于2010年5月行右侧开放性根治性肾切除术,无重大并发症。肾组织病理学检查发现常规(透明细胞)肾细胞癌和小乳头状肾细胞癌。非肿瘤性肾实质检查显示局灶节段性肾小球硬化的改变,以及轻度动脉性肾硬化。肾切除术后5年未发现肿瘤转移。她的血清肌酐和肾小球滤过率在肾切除术后5年内逐渐恶化。该患者肾功能逐渐恶化,且恶化程度较轻,因此在肾和肾盂肿瘤的肾切除术中报告非肿瘤性肾脏病变/疾病的重要性。她出现水肿,进行性蛋白尿达到6.5 g/d,血清肌酐水平为4.2 mg/dL(肾切除术时基线血清肌酐为0.7 mg/dL)。早期诊断有助于医学管理和延缓医学肾病的进展。一般/外科病理学家在评估手术肾切除术时应采用一种简单的非肿瘤性肾实质组织算法方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Conventional and Papillary Renal Cell Carcinomas and Focal Segmental Glomerulosclerosis in a Nephrectomy
This is a case report of a 63-year-old morbidly obese (body mass index, 46.5 kg/m2) African American woman with a medical history of recurrent urinary tract infections, diverticulosis/diverticulitis, duodenitis, colovesical fistula, gout, hypertension, degenerative joint disease, carpal tunnel syndrome, a 20-pack-year history of tobacco use, and bilateral axillary hidradenitis suppurativa. After multiple episodes of gross hematuria and suprapubic discomfort, a computed tomographic scan showed a solid mass in the lower pole of the right kidney. The patient underwent right open radical nephrectomy in May 2010 without major complications. A conventional (clear cell) renal cell carcinoma and a small papillary renal cell carcinoma were found upon histopathologic examination of the kidney. Examination of the nonneoplastic renal parenchyma revealed changes indicative of focal segmental glomerulosclerosis, as well as mild arterial nephrosclerosis. No tumor metastases were detected at 5 years after nephrectomy. Her serum creatinine and estimated glomerular filtration rate gradually deteriorated in the 5 years after nephrectomy. The gradual, less steep renal function deterioration of this patient emphasizes the importance of reporting nonneoplastic renal lesions/diseases in nephrectomies for kidney and renal pelvis tumors. She developed edema, progressive proteinuria reaching 6.5 g/d, and serum creatinine level of 4.2 mg/dL (baseline serum creatinine at time of nephrectomy was 0.7 mg/dL). The early diagnosis helped medically manage and delay the progression of the medical renal disorder. An easy algorithmic approach for nonneoplastic renal parenchymal tissue should be adopted by general/surgical pathologists when evaluating surgical nephrectomies.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊介绍: Each issue of Pathology Case Reviews examines one vital theme in the field with peer-reviewed, clinically oriented case reports that focus on diagnosis, specimen handling and reports generation. Each theme-oriented issue covers both histopathologic and cytopathologic cases, offering a comprehensive perspective that includes editorials and review articles of the newest developments in the field, differential diagnosis hints, applications of new technologies, reviews of current issues and techniques and an emphasis on new approaches.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信