Biomedical Research

A Japanese woman in her mid-seventies presented with a case of urothelial carcinoma (UC) of the renal pelvis showing a peculiar gland-like lumina (GLL) pattern and exhibiting no evident glandular structure or mucin production. She showed macroscopic hematuria and experienced left lumbar pain for 2 months. After detailed examination, renal pelvic tumor and bilateral cortical adenoma of the adrenal glands were diagnosed, followed by nephrectomy and adrenalectomy of the left kidney by using the retroperitoneal laparoscopic method. Histopathological examination of the pelvic tumor revealed a grade 2 UC with GLL, which exhibited a smooth transition from ordinary UC to GLL with respect to its morphology. No mucinophilic materials were detected in the GLL areas, which showed distinct trabecular, circular, or meshwork arrangement of tumor cells without a defined glandular structure. Immunohistochemical findings showed that both ordinary UC and peculiar GLL areas were similarly stained when cytokeratin antibodies such as AE1/AE3, CAM5.2, CK7, CK20, and p63, were used. No neuroendocrine differentiation was detected in the GLL. Additionally, the average MIB-1 labeling index of the UC was 5%, but was almost negligible in the GLL areas. Furthermore, the GLL possessed only weak proliferative activity. Thus, prognosis of such a UC with GLL is probably similar to that of an ordinary UC without the GLL. Because of its rarity and the presence of a peculiar histopathological pattern of tumor cells, the histogenesis of such a tumor should be further investigated in further accumulated cases. (to be the same character with the others, please)

Author(s): Yuji Ohtsuki, Naoto Kuroda, Tokuhiro Iseda, Yuhei Okada, Yuki Matsuka, Masako Izumimoto, Wakana Tanihata, Gang-Hong Lee, Mutsuo Furihata
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