Case Report Eur Urol 1992;22:171-173
Y. Koikawa N. Sakamoto S. Naito M, Tanaka T. Ueda J. Kumazawa
Bellini Duct Carcinoma of the Kidney
1617079
Department of Urology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
Key Words
Abstract
Bellini duct carcinoma Immunohistochemical reaction
Human epithelial cells of the kidney present a wide spectrum of cytological and histological variation. The normal epithelium of the kidneys also includes a number of morphologically and functionally different cell types which are arranged along the nephrons and collecting ducts. Although renal carcinoma can involve any type of renal cell, the most common is renal cell carcinoma of the proximal tubuli. Here, we present the case of a 65-year-old Japanese patient with a renal cell carcinoma arising from Bellini duct epithelial cells. State-of-the-art techniques were used to establish the diagnosis and histogenesis of this renal cell carcinoma.
Renal cell carcinomas usually involve epithelial cells from the proximal collecting tubuli. However, other cell types might be involved as well, but the classification and histogenesis of renal cell tumors have not been clearly established. Recently developed tech niques seem promising and may allow us to solve these problems. Using state-of-the-art techniques, the Bellini duct carcinoma has been identified as a new entity within the spectrum of renal cell carci nomas. Generally, this renal cell carcinoma has a microscopic papil lary structure. Here, we report a case of renal cell carcinoma showing various microscopic patterns that was diagnosed as Bellini duct car cinoma based on the results of immunohistochemical studies. The immunohistochemical techniques employed included: reaction to epithelial membrane antigen (EMA), cytokeratins AE1 and CAM5.2, CD15, lotus tetragonolobus (LTL), vimentin (VM), soy bean agglu tinin (SBA), peanut agglutinin (PNA) and dolichos biflorus agglu tinin (DBA).
Case Report A 65-year-old Japanese man was admitted to our hospital with a right renal mass. Urologie work-up revealed a mass in the upper por tion of the right kidney that was 39 mm long and 41 mm wide. Sonography, computerized tomography and magnetic resonance imaging findings were compatible with those of a solid mass. DSAangiography showed a normal vascularity. The results of an evalua tion for metastatic disease were negative. Thus, the preoperative diagnosis was: right renal cell carcinoma stage 1. The patient underwent surgical exploration through a right sub costal incision, and right partial nephrectomy was performed. The lesion in the bivalve specimen was 40 mm long and 43 mm wide, red-whitish and attached to the posterior-superior pelvic epithelium with extension into the cortex. Histologically, this carcinoma was grade II and involved renal cells with a granular cytoplasm that had proliferated forming solid tubular, anastomosing tubular, papillary and glomeruloid patterns (fig. 1). As this tumor showed various microscopic patterns, several immunohistochemical stainings were performed to establish the ori gin of the tumor (table 1). The tumor cells were positive for both proximal and distal tubular markers the same as the Bellini ducts were stained in the normal nephrons. Consequently, we diagnosed this tumor as a Bellini duct carcinoma.
Y. Koikawa Department of Urology Faculty of Medicine Kyushu University Fukuoka 812 (Japan)
© 1992 S. Karger AG, Basel 0302-2838/92/0222-0171 $2 75/0
Downloaded by: University of Exeter 144.173.6.94 - 5/3/2020 4:03:08 PM
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Y. Koikawa N. Sakamoto S. Naito M, Tanaka T. Ueda J. Kumazawa
Bellini Duct Carcinoma of the Kidney
1617079
Department of Urology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
Key Words
Abstract
Bellini duct carcinoma Immunohistochemical reaction
Human epithelial cells of the kidney present a wide spectrum of cytological and histological variation. The normal epithelium of the kidneys also includes a number of morphologically and functionally different cell types which are arranged along the nephrons and collecting ducts. Although renal carcinoma can involve any type of renal cell, the most common is renal cell carcinoma of the proximal tubuli. Here, we present the case of a 65-year-old Japanese patient with a renal cell carcinoma arising from Bellini duct epithelial cells. State-of-the-art techniques were used to establish the diagnosis and histogenesis of this renal cell carcinoma.
Renal cell carcinomas usually involve epithelial cells from the proximal collecting tubuli. However, other cell types might be involved as well, but the classification and histogenesis of renal cell tumors have not been clearly established. Recently developed tech niques seem promising and may allow us to solve these problems. Using state-of-the-art techniques, the Bellini duct carcinoma has been identified as a new entity within the spectrum of renal cell carci nomas. Generally, this renal cell carcinoma has a microscopic papil lary structure. Here, we report a case of renal cell carcinoma showing various microscopic patterns that was diagnosed as Bellini duct car cinoma based on the results of immunohistochemical studies. The immunohistochemical techniques employed included: reaction to epithelial membrane antigen (EMA), cytokeratins AE1 and CAM5.2, CD15, lotus tetragonolobus (LTL), vimentin (VM), soy bean agglu tinin (SBA), peanut agglutinin (PNA) and dolichos biflorus agglu tinin (DBA).
Case Report A 65-year-old Japanese man was admitted to our hospital with a right renal mass. Urologie work-up revealed a mass in the upper por tion of the right kidney that was 39 mm long and 41 mm wide. Sonography, computerized tomography and magnetic resonance imaging findings were compatible with those of a solid mass. DSAangiography showed a normal vascularity. The results of an evalua tion for metastatic disease were negative. Thus, the preoperative diagnosis was: right renal cell carcinoma stage 1. The patient underwent surgical exploration through a right sub costal incision, and right partial nephrectomy was performed. The lesion in the bivalve specimen was 40 mm long and 43 mm wide, red-whitish and attached to the posterior-superior pelvic epithelium with extension into the cortex. Histologically, this carcinoma was grade II and involved renal cells with a granular cytoplasm that had proliferated forming solid tubular, anastomosing tubular, papillary and glomeruloid patterns (fig. 1). As this tumor showed various microscopic patterns, several immunohistochemical stainings were performed to establish the ori gin of the tumor (table 1). The tumor cells were positive for both proximal and distal tubular markers the same as the Bellini ducts were stained in the normal nephrons. Consequently, we diagnosed this tumor as a Bellini duct carcinoma.
Y. Koikawa Department of Urology Faculty of Medicine Kyushu University Fukuoka 812 (Japan)
© 1992 S. Karger AG, Basel 0302-2838/92/0222-0171 $2 75/0
Downloaded by: University of Exeter 144.173.6.94 - 5/3/2020 4:03:08 PM
Introduction
b
a 4*
* es, «V %»i
I *
®
v«
