Solitary Fibrous Tumor of the Urinary Bladder

Solitary fibrous tumor (SFT) is a distinct spindle cell tumor arising mainly in the pleura, however, SFT of extra-pleural sites had been reported. To our knowledge, five cases of the urinary bladder SFT had been reported. We have recently experienced a case of SFT of the urinary bladder in a 56-year- old man who was admitted to the hospital with a 4-month history of voiding difficulty, frequency, and residual urine sensation. A computerized tomography scan revealed a 12cm sized intravesical mass. The mass was marginally excised under the impression of it being a benign spindle cell tumor by pre-operative needle biopsy. On gross examination, the mass was multinodular, creamy white, and the cut surface was fibrotic with a rubbery consistency. Microscopic examination revealed haphazardly arranged spindle cells with a lace-like deposition of inter- and pericellular collagen. Areas of increased cellularity show nuclear atypia and occasional mitoses (2-3/10HPF). The immunohistochemical staining revealed an intense CD34 and bcl-2 immunoreactivity. Although the exact biologic behavior of these tumors has not been clarified, most of the reported cases have undergone a benign clinical course.

Regional Lymph Node Involvement by Renal Angiomyolipoma / 대한비뇨기과학회지

Renal angiomyolipomas are benign mixed mesenchymal tumors, which are composed of atypical blood vessel, smooth muscle and fat cells. A 34-year-old woman presented with a palpable right abdominal mass, accompanied with discomfort. A CT scan showed a large right perinephric mass, with heterogeneous density, surrounding the kidney, with enlargement of the regional lymph nodes. The presumptive diagnosis was one of a malignant tumor of the retroperitoneum, with lymph node metastasis or an angiomyolipoma, involving both the kidney and lymph nodes. A right radical nephrectomy, including the tumor, was performed. The final diagnosis was an angiomyolipoma arising from the kidney, with the dissected lymph nodes having the same pathology. There was no evidence of a tumor recurrence during the six month follow-up period. This was an unusual case of a multicentric angiomyolipoma.

Age-Specific Reference Ranges for Serum Prostate-Specific Antigen: Community-based Survey in Namhae Region / 대한비뇨기과학회지

PURPOSE: To establish the relationship between serum prostate specific antigen (PSA) concentration and age in a community-based population without clinically evident prostate cancer, a population based screening study was performed in a rural area in Southern Korea. MATERIALS AND METHODS: From January 1999 to December 1999, 1,278 volunteer men aged from 40 to 89 years in Namhae, Korea participated in a clinical examination that included a serum PSA determination (TANDEM-R assay), digital rectal examination and transrectal ultrasonography. The subjects who had clinical evidence of prostate cancer and high PSA concentration (>10ng/ml) were excluded. The PSA levels were compared with age using Pearson correlation and linear regression analysis. RESULTS: The serum PSA concentration correlated with patient age (r=0.129, p=0.001). The observed 95th percentile increased from 1.37ng/ml for subjects in the 40's to 6.18ng/ml for subjects in the 80'2. The reference range for serum PSA (95 percentile) for men in the 40's was 0.24 to 1.37ng/ml; for 50 to 59 years, 0.27 to 2.68ng/ml; for 60 to 69 years, 0.25 to 4.00ng/ml; for 70 to 79 years, 0.29 to 4.55ng/ml; and for 80 to 89 years, 0.31 to 6.18ng/ml. CONCLUSIONS: Our data showed that the serum PSA concentration directly correlated with patient age (Pearson correlation coefficient=0.129, P=0.001). Thus, rather than relying on a single reference range regardless of different age groups, it may be more appropriate to have age-specific reference ranges. Our data were lower than that of the Western data, and could provide an adjunctive information in interpreting PSA data in Korean men, especially in the elderly population.