CASE N°27 – Renal Papillary Urothelial Carcinoma

Clinical History:

Age: 77

Sex: Male

Hematuria and left flank pain.
Ultrasound: Renal parenchyma within the limits, not dilated urinary tract bilaterally

Cytological Images:

Cytological speciemen: Renal Washing

10115658

10115720

10115740

10115756

10115849

Cytological Report:

Positive for malignancy: numerous pseudo-papillary aggregates of malignant cells, transitional type.

Histological Images:

Histological speciemen: Renal Biopsy

10115951

10120013

10120114

10120148

Histological Report:

Papillary Urothelial Carcinoma, high grade

Discussion:

Renal pelvis tumors account for 5-10% of all renal tumors and about 5% of urothelial tumors. Rarely occur before age 40, with a peak incidence between the 6th-7th decade and an average age of 65 years.
Histologically, 90% are transitional forms, the 0.7-7% squamous cell carcinoma, adenocarcinoma 1%.
It should be noted that in 2-4% of cases, the lesion is synchronous or metachronous contralateral lesions of the urinary tract, and 30-50% of the lesions was followed by a pathology of urothelial bladder.
A significant increase in the risk of developing urothelial tumors or pelvic has been reported in workers in chemical, petrochemical and plastics, and in workers exposed to coal, asphalt and bitumen.
The most common symptom is the total gross hematuria, which occurs in 75% of cases.
The flank pain is found in 30% of patients
Ultrasound: for the tumors located in the upper urinary tract it has a diagnostic value significantly lower than urography, as in this case.
Urography: 50-70% of patients had a filling defect

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: