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Mass in renal pelvis.

Diana Taheri, MD

Al-Zahra Medical Center Al-Zahra Medical Center. School of Medicine
Isfahan University Of Medical Sciences
Isfahan

Irán, República Islámica de
Comentado en:
PATOLOGIA
PATOCITO
FOROPAT
 Historia Clínica
52 year old male with history of hematuria underwent nephroureterectomy. A soft grayish red mass with papillary configuration measured 15mm in diameter was seen in renal pelvis.

In microscopic examination a low grade transitional cell carcinoma located in renal pelvis, but in medulla near the tumor there is conspicuous dysplasia in collecting duct tubules.

Do you agree with dysplasia in collecting duct tubules?
What about tubular involvement by TCC in medulla?
And what is your opinion about that?
I would be very grateful for any thought.
 Iconografía
Imagen de Mass in renal pelvis.
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Imagen de Mass in renal pelvis.
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Imagen de Mass in renal pelvis.
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 Comentarios

 

El 24/10/2005 19:26, Ricardo Drut dijo:

Transitional cell carcinoma of the renal pelvis extending into the m medullary collecting ducts.

Fig. 3 is not so good, mainly because tecnical problems with the section.

 

El 24/10/2005 22:25, Dan Pankowsky dijo:

I think there is extension of tumor up the collecting tubules. I think this is one tumor, not two.

 

El 24/10/2005 22:52, Pheroze Tamboli dijo:

I agree with Ricardo and Dan. This is extension of TCC along the collecting ducts. Extension along the collecting ducts by TCC is not uncommon, especially for tumors located in the minor calyx or on the renal papilla.

Figs 2 and 3 show poor preservation of the tubules and that may be the reason for the "atypia". These cells seem to be falling apart and are not well-preserved.

 

El 24/10/2005 23:02, Leopoldo E. Santamaría dijo:

Transitional cell carcinoma (low grade; probably the third image presents technical problems.... where I could not arrive to a diagnostic impression...

 

El 25/10/2005 7:10, Reynaldo Falcón-Escobedo dijo:

The possibility of TCC with extension into the medullary colecting ducts is very reasonable...however the TCC appears as low nuclear grade and the discohesive cells into collecting ducts seems at least of nuclear grade II, and not very similar to the TCC cells. If it is possible, I would have immunohistochemistry for CK7, CK19, CK AE1, B-catenin, E-cadherin (positive in TCC) and Bcl2 (positive in collecting ducts carcinoma)and solve the diagnosis beyond of our opinions with H&E.

 

El 25/10/2005 7:58, Maria Laura Fibbi dijo:

I think that the lesion is a transitional cell carcinoma (grade 1) extended to the kidney medulla

 

El 25/10/2005 9:07, andrea gianatti dijo:

Urothelial carcinoma, low grade, of the renal pelves.

It is difficult to value the ducts; although involvement of renal collecting ducts without parenchymal invasion does not alter the stage (tnm,2002).

 

El 25/10/2005 10:14, Clóvis Klock dijo:

TCC with extension into the medullary colecting ducts.

Clóvis

 

El 25/10/2005 17:10, Francisco Serpas dijo:

My opinion: CCT with estension to the colectin tubules.

Best regards

 

El 27/10/2005 2:36, Omaira Valencia Valencia dijo:

Urothelial carcinoma, low grade, of the renal pelvis. I don’t agree with dysplasia in collecting duct tubules because Figs 2 and 3 show poor preservation of the tubules and that may be the reason for the "atypia".

best regards

OVV/

 

El 29/10/2005 12:20, Esther Contreras valerio dijo:

Transitional cell Carcinoma of the pelves, con extention a tubules.

Esther.

Hacer un comentario a este caso
 Diagnóstico
LOW GRADE TCC WITH EXTENDING INTO THE MEDULLARY COLLECTING DUCTS.

 Comentario del Autor
Thank you so much for your help, I really appreciate that.

I received our colleagues suggestion, in agreement with you and other colleagues I believed that this is a low grade TCC with extending into the medullary collecting ducts with some collecting ducts dysplasia.

Thank you just the same

Best regards

Diana


Diana Taheri,MD,Pathologist(d_taheri@med.mui.ac.ir)
Al-Zahra Medical Center
School of Medicine
Isfahan University Of Medical Sciences
Isfahan
Iran

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