Inflammatory Myofibroblastic Tumor Report of a Rare Case in Kidney

Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm mostly seen in the lungs, but also in extrapulmonary sites. The most common genitourinary site of IMT is the bladder, but it may rarely be seen in the kidneys. We report a case of a 15-year-old girl presented with flank pain and hematuria, in which computed tomography scan revealed a mass in the left kidney. The patient underwent left nephrectomy for a diagnosis of Wilms tumor. Further assessment of the tissue demonstrated a pathologic diagnosis of IMT. Despite improvements in imaging technology, the preoperative diagnosis of IMT remains difficult and surgery is the only way for the diagnosis and treatment. Considering the role of the pathologic examination in making the definite diagnosis of IMT, we should be aware of this entity and it must be considered in the differential diagnoses

An Iranian experience on renal allograft diseases

Background: Renal transplantation is the treatment of choice for most patients with end stage renal disease. In addition, renal biopsy is the gold standard to assess the causes of renal allograft dysfunction. This study was designed to evaluate and designate renal lesions according to Banff schema. Methods: In this cross-sectional study, all renal allograft biopsies obtained from renal transplant patients at Alzahra and Noor referral hospitals in Isfahan during 2006-2008 were studied. Evaluations were made according to the Banff classification 2009. Clinical data was collected from the pathology database and analyzed using SPSS. Results: A total number of 161 specimens were studied from 68% male and 32% female subjects. The donor source was living unrelated in 85%, living related 9.9% and cadaveric in 5% of cases. Pathologic results showed 22.4% acute tubular necrosis (ATN), 13.7% interstitial fibrosis and tubular atrophy (IF/TA) grade II, 9.9% IF/TA (Grade III), 6.8% acute T-cell mediated rejection (TCMR-IA), 5.6% TCMR-IB, 5% borderline change, 5% infarction, 4.3% TCMR-IIA, 4.3% TA/IF (Grade I), 3.7% acute antibody-mediated rejection (ABMR), 1.9% TCMR-IIB and 17.4% other lesions. Conclusions: The commonest causes of graft dysfunction after kidney transplant were IF/TA, no evidence of any specific etiology (NOS) and ATN. Living donors were found to be important sources for kidney transplantation in Iran

Pathological diagnosis of antibody-mediated rejection in renal allograft without c4d staining, how much reliable?

Background: C4d as a part of complement activation process is a marker for detecting antibody-mediated rejection (ABMR) and its positivity accompanied by positive donor specific antibody (DSA), and morphologic view of humoral rejection has been suggested to detect ABMR since 2003. Materials and Methods: 41 specimens of transplanted kidney biopsies gathered from 2006 to 2008 were evaluated for morphological changes on light microscopy, and nephro-pathologist made distinct diagnosis for all of specimens then c4d staining was done for all of them. The association between primary diagnosis without c4d staining and c4d scoring on peritubular capillaries and glomerular capillaries were evaluated to determine whether morphological changes were enough for distinct diagnosis or not. Results: Acute tubular necrosis (ATN) 27%, interstitial fibrosis and tubular atrophy (IF&TA) 17%, and T cell mediated rejection (TCMR) 22% were the commonest diagnosis on light microscopy, and 17% of all biopsies had diffuse positive c4d staining. There was not any report of ABMR in morphological evaluation while c4d positive staining was seen in some specimens (17%). It may result from masking of ABMR by other morphological changes such as TCMR and no specific histologic changes for ABMR on light microscopy. Conclusion: We would like to emphasize that c4d staining should be done for all of renal allograft biopsies, and pathologists all over the world should consider the probability of ABMR masked by other morphological changes on light microscopic evaluation

Cancer problem in Peutz-Jeghers syndrome

Peutz-Jeghers syndrome is a rare autosomal dominantly inherited condition, characterized by the presence of hamartomatous gastrointestinal polyps and mucocutaneous pigmentation. Patients with this syndrome can be associated with other neoplasms such as ovarian neoplasms known as sex-cord tumor with annular tubules that are associated in one third of the cases with this syndrome and other types of malignancies. We report a 42-year-old woman with a history of Peutz-Jeghers Syndrome and bilateral breast cancer that presented with abnormal uterine bleeding. Total abdominal hysterectomy with bilateral salpino-oophorectomy was done and an ovarian sex cord tumor with annular tubules was incidentally diagnosed. By reviewing literatures and in agreement with previous studies we suggest routine screening for malignancies in patients with Peutz-Jeghers syndrome

Minimal Invasive Urologic Surgery and Postoperative Ileus

info:eu-repo/semantics/inPres