1/205. Organ-preserving surgery of renal cell carcinoma: report of four cases. Authors removed the renal tumour of four patients by means of resection in an organ-preserving manner. Of the four patients, one had bilateral carcinoma. The right-sided carcinoma of this patient was removed by resection while the other kidney was removed radically, by transabdominal approach. In three of the four cases which were in the process of stages T1 and N0M0, organ-preserving surgery was performed in the presence of intact opposite kidneys. Authors point out the fact that the resection method might be indicated even in the case of early (T1) stage tumours with intact opposite side kidneys. Furthermore, they do not recommend the enucleation of renal carcinomas for the surgical treatment of kidney tumours, since experimental studies have proved that these tumours can be transferred into the parenchyma of the kidney through the pseudocapsule of the tumour. ( info) |
2/205. kidney oncocytoma. Authors review the case history of three patients with kidney tumours which had been surgically removed. In two of the cases radical nephrectomy while in one, organ-preserving surgery was performed. In all the cases histology revealed benign kidney tumours--oncocytomas. In light of the available literature authors indicate that preoperative diagnosis is almost impossible. Furthermore, it is their opinion that this benign kidney tumour has a less frequent occurrence than earlier thought. ( info) |
3/205. A peculiar factor viii-related antigen staining of an oxyphilic cell nodule within an intrathyroidal parathyroid adenoma. A case of intrathyroidal parathyroid adenoma, which was found in the lower portion of the right thyroid lobe, is presented. The nodule in this lesion was composed of oxyphilic cells. In order to verify a possible vascular invasion, immunohistochemical study with factor viii-related antigen/von willebrand factor, which is known to be synthesized by the endothelial cells and stored in weibel-palade bodies, and ulex europaeus lectin 1 were applied. It was interesting to find positivity for factor viii-related antigen and ulex europaeus lectin I strictly confined in the nodule of oxyphil cells, which are known to have large numbers of mitochondria. This led to investigating similar immunoreactions in different lesions of oxyphilic cells with several other markers. The possible cross-reaction between weibel-palade bodies and mitochondria deserves further detailed research. ( info) |
4/205. FDG PET-negative liver metastases of a malignant melanoma and FDG PET-positive hurthle cell tumor of the thyroid. A Hurthle cell tumor (oncocytoma) of the thyroid presented as a hypermetabolic focus in a fluorodeoxyglucose positron emission tomography (FDG PET) study which was performed as staging procedure in a patient with malignant melanoma. This finding led to the initial diagnosis of a metastasis. In contrast, multiple liver metastases, seen on MRI and sonography, did not show any increased FDG uptake. Cytology results of one liver mass confirmed a melanoma metastasis, and of the neck mass, a Hurthle cell tumor. The Hurthle cell tumor was, based on clinical evidence, thought to be benign. This is the first description of a FDG PET-positive benign Hurthle cell tumor, with FDG PET-negative liver metastases of a malignant melanoma, in the same patient. ( info) |
5/205. Adrenocortical oncocytoma. The histopathology and ultrastructural features of an adrenocortical oncocytoma are reported. The tumour was discovered incidentally during investigation for hypertension in a 72 year old female. Oncocytic tumours of the adrenal cortex are rare, with only 20 examples described in English language reports. Most have been non-functioning and benign, like the present example. Molecular studies may help assess the significance of oncocytic change in the pathogenesis and behaviour of oncocytic neoplasms. ( info) |
6/205. Oncocytoid renal cell carcinoma after neuroblastoma: a report of four cases of a distinct clinicopathologic entity. Four children who developed oncocytoid renal cell carcinoma (RCC) after neuroblastoma are reported. One patient had multiple, bilateral RCCs. The mean age at time of diagnosis of RCC was 8.8 years (range, 5-13 years). The mean interval between neuroblastoma and RCC was 7.15 years (range, 3.1-11.5 years). The histologic findings of these RCCs did not fit within the spectrum of known renal epithelial neoplasms. Most of the neoplastic cells in all cases had eosinophilic, oncocytoid cytoplasm and were arranged in solid and papillary growth patterns. A subset of cells with reticular cytoplasm was also present. Immunohistochemical studies demonstrated keratins 8 and 18 in all neoplasms and keratin 20 in two cases. dna ploidy analysis revealed that two of three neoplasms assessed were aneuploid. Cytogenetic studies revealed 45, XX, add or dup (7)(q32q36) in one neoplasm, and 83-89, XXXX, -1 ,-3, del (3)(q11.1q2?1), der(4)t(4;?22) (q32;q11.2), -14, -22 in a second tumor. Microsatellite polymerase chain reaction analysis detected no abnormalities in one neoplasm and allelic imbalance of chromosomes 2p31-32.2, 8p22, 9p22-24, 13q22, 20q13, and 22q11 in a second tumor. In case 4, two different RCCs excised 6 months apart were analyzed. The initial neoplasm showed allelic imbalance of chromosomes 2q31-32.2, 5q22, 5q31, 10p13-14, 13q22, 14q31, and 20q13. The subsequent neoplasm showed allelic imbalance of chromosomes 3p21.3, 14q31, and 20q13. The common presence of 14q31 and 20q13 abnormalities suggests that these two neoplasms were genetically related. In aggregate, these findings are distinctive, are not found in known types of RCC, and support the morphologic impression that oncocytoid RCC after neuroblastoma is a distinct clinicopathologic entity. ( info) |
7/205. Multicentric oncocytoma of the lung diagnosed by fine-needle aspiration. A 50-yr-old man presented with dyspnea. On chest X-ray, multiple pulmonary nodules were observed. Fine-needle aspiration biopsy (FNAB) showed tridimensional aggregates of atypical round epithelial cells, containing numerous cytoplasmic granules. The tissue fragment confirmed the presence of an epithelial tumor composed of trabecular sheets of clear cells, with numerous cytoplasmic granules which stained with phosphotungstic acid hematoxylin (PTAH). Immunohistochemically, the tumor cells were positive for cytokeratins and antimitochondrial antigen, whereas chromogranin, synaptophysin, S-100 protein, and HMB-45 were negative. Clinical and tomographic studies ruled out any tumor mass elsewhere. The rarity of this lesion in the lung and the potential difficulties for its diagnosis prompted us to report the clinical, cytological, and immunohistochemical findings in this case. ( info) |
8/205. Metastatic renal oncocytoma: A case report and review of the literature. Oncocytic renal tumour is an uncommon tumour and considered by many to be benign. Metastases are extremely rare. A case of renal oncocytoma with extensive skeletal metastases is described and the relevant literature reviewed. ( info) |
9/205. Clinics in diagnostic imaging (36). Benign renal oncocytoma. A 50-year-old Indian man presented with non-specific right-sided abdominal pain. Ultrasound of the abdomen demonstrated a small right renal tumour. Computed tomography showed features suggestive of a benign renal oncocytoma. This was confirmed by frozen section during surgical exploration. A partial nephrectomy was carried out. The role and limitations of imaging in the management of solid renal masses is discussed. ( info) |
10/205. Malignant oncocytoma of the nasal cavity: a case report. Malignant oncocytoma is a rare clinical entity and is most commonly seen in the salivary glands. Its occurrence in the nasal cavity is extremely rare, and only 4 such cases have been reported in the literature. The authors report one such case in a 60-year-old woman, which presented as a slow-growing nasal mass arising from the nasal septum, with no lymph node metastasis, which was successfully managed by a combined modality of treatment-surgery followed by radiation therapy. The relevant literature has been reviewed. The case is discussed as a possible differential diagnosis for a mass in the nose. ( info) |