Extrarenal multiorgan metastases of collecting duct carcinoma of the kidney: A case series

<p>Abstract</p> <p>Introduction</p> <p>Collecting duct carcinoma is a rare type of renal cell carcinoma. The primary is difficult to diagnose on imaging, and metastases are often present on initial presentation. Extensive multiorgan metastases can result in complex presentations that can be difficult to diagnose.</p> <p>Case presentation</p> <p>We present two case reports of multiorgan metastases of collecting duct carcinoma that were autopsy confirmed. The first case was a 55-year-old man who presented with fever and abdominal pain. Abdominal computed tomography showed enlargement of the right kidney. Pyelonephritis was considered on the basis of laboratory test results and imaging findings. However, multiple cavitary lesions were found on routine chest radiography. These lesions were biopsied, resulting in a histological diagnosis of metastatic adenocarcinoma. A renal tumor was considered. Transitional cell carcinoma was suspected, which proved to be misdiagnosed and chemotherapy was given accordingly. However, this was not effective and the patient died after 2 months. Autopsy demonstrated the primary tumor to be collecting duct carcinoma, with metastases to lung, liver, spleen, bone marrow, right adrenal gland, and para-aortic lymph node. Computed tomography done while the patient was alive detected lung, liver, and para-aortic lymph node metastases. The second case was a 77-year-old man who presented with fever. Pyelonephritis was considered on the basis of the laboratory test results and imaging findings. Antibiotic therapy improved his symptoms and laboratory indicators of inflammation. One year later, he developed backache. Computed tomography revealed a progressively enlarging right renal lesion, multiple liver masses, enlargement of the para-aortic lymph nodes, and multiple osteoblastic and osteoclastic lesions. A renal tumor with multiple metastases was diagnosed. Chemotherapy was given without effect, and the patient died of cardiac failure 1 year later. Autopsy revealed a primary tumor of collecting duct carcinoma with metastases to the liver, right adrenal gland, right upper ureter, bone marrow, para-aortic and mediastinal lymph nodes, and bone.</p> <p>Conclusion</p> <p>We present the radiological findings of lung, liver, lymph node, and bone metastases in two patients with collecting duct carcinoma.</p

Seedling biomass and element content of Pinus sylvestris and Pinus nigra grown in sandy substrates with lignite

Copyright © 2006 Elsevier B.V. All rights reserved.Reclaimed mine soils in the Lusatian mining district (Eastern Germany) are often comprised of sandy materials containing high amounts of lignite. Lignite can absorb nutrients and water, but its high pyrite and Al content may restrict access of roots to these pools. We assessed the influence of lignite on growth, seedling shoot and root element content and root lengths of Pinus sylvestris L. and Pinus nigra Arn. in lignite-containing and lignite-free substrates. Rhizotrons were filled with mining substrate in which lignite was finely dispersed (L-substrate), a model substrate with alternating layers of quartz sand and lignite (SL-substrate), and a sandy substrate from a natural forest without lignite (S-substrate). After 11 months, shoot dry mass of P. sylvestris significantly decreased in the following order: S-substrate > SL-substrate > L-substrate, whereas root dry mass was similar in all substrates. P. sylvestris in S-substrate was characterized by high shoot and root contents of N and P, whereas plants grown on L-substrate had high shoot and root contents of Ca and a high root content of Al. In L-substrate, shoot dry mass of P. nigra was significantly greater than that of P. sylvestris and the Ca content in the roots of P. nigra was twice as high than in P. sylvestris roots (P ≤ 0.1). The high Ca content in the roots may explain the better growth of P. nigra in these mining substrates which are often characterized by high Al content. © 2006 Elsevier B.V. All rights reserved.K. Baumann, A. Rumpelt, B.U. Schneider, P. Marschner and R.F. Hüttlhttp://www.elsevier.com/wps/find/journaldescription.cws_home/503332/description#descriptio