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.

The Clinical Utility of BTA TRAK, BTA stat, NMP22 and Urine Cytology in the Diagnosis of Bladder Cancer: A Comparative Study / 대한비뇨기과학회지

PURPOSE: Various tumor markers, developed recently for the diagnosis of bladder cancer, are reported to be superior to urine cytology in terms of their sensitivity and non-invasiveness. A prospective study was performed to evaluate the efficacies of BTA TRAK, BTA stat, NMP22 tests and urine cytology. MATERIALS AND METHODS: Between August 2001 and December 2001, 154 patients were involved in the study. Voided urine was used to perform BTA TRAK, BTA stat, NMP22 tests and cytology. The final diagnoses were pathologically proven transitional cell carcinoma (TCCa) of the bladder in 34 patients, gross or microscopic hematuria without detectable tumor in 27, history of TCCa without evidence of recurrence in 68 and benign urologic diseases in 25. RESULTS: The sensitivities of the BTA TRAK, BTA stat, NMP22 and urine cytology were 82.4, 79.4, 61.8 and 32.4%, respectively. The specificities were 75.8, 70.8, 95.8 and 92.5%, respectively. When the sensitivity was subdivided according to the tumor stage, grade and size, the bigger size yielded higher sensitivities in the NMP22 and BTA TRAK (p<0.01 and p=0.03, respectively). When the results of the urine cytology were combined with each of the other tests, the specificity was lower than each test alone for the BTA TRAK and BTA stat, while sensitivity and specificity were both higher than each test alone for the NMP22. CONCLUSIONS: The BTA TRAK, BTA stat and NMP22 tests are useful in overcoming the limitations of cystoscopy and cytology as the initial evaluation tools for patients where bladder cancer is suspected. In particular, the NMP22 may be more useful due to its enhanced specificity when combined with the urine cytology.

Primary Amyloidosis of the Urinary Tract / 대한비뇨기과학회지

Primary localized amyloidosis of the urinary tract is very rare disease. A 72-year-old man, with a history of urethral injury, had a stricture of the anterior urethra about 6cm in length. A segmental resection of urethra and urethroplasty, with penile skin flap, was performed. The resected urethral segment was diagnosed as urethral amyloidosis. There was no involvement of amyloidosis oin the other organs (heart, gastrointestinal system, joint, kidney, skin etc) and no underlying disease (multiple myelomas, rheumatism, cancer, chronic inflammation etc). Also, a 75-year-old woman, with a history of intermittent gross hematuria, had a stricture of the lower ureter. During diagnostic ureteroscopy, there was an irregular mucosal change of her lower ureter. An intraoperative biopsy showed ureteral amyloidosis. Here, we report on these two cases of primary amyloidosis of the urinary tract.