ABSTRACT
Adrenal-renal fusion with adrenal cortical adenoma is a rare anomaly with only a few cases described in the literature. Imaging-based identification of this anomaly remains a diagnostic challenge, making it difficult to differentiate upper pole renal malignancy from adrenal cortical adenoma. We describe a case of a 62-year-old woman with an upper pole cystic renal mass on imaging, who underwent robotic partial nephrectomy. Intraoperatively the renal mass was found to be an adrenal-renal fusion anomaly, with ectopic adrenal tissue. Adrenal-renal infusion of an adrenal cortical adenoma was confirmed on final pathology. Due to lack of imaging-based diagnosis, this condition should be considered in the differential for upper pole renal masses.
ABSTRACT
OBJECTIVE: To investigate the expression status and clinical significance of cytoprotective proteins to human renal allografts. METHODS: Expressions of cytoprotective proteins: antiapoptotic protein (A20), hemeoxygenase-1 (HO-1), and B-cell lymphoma/leukemia-X(L) (Bcl-X(L)) were analyzed by immunohistochemistry and compared in 30 renal allografts, including 10 grafts undergoing acute rejection (AR), 10 grafts undergoing chronic rejection (CR), and 10 nonrejecting (NR) grafts. RESULTS: Expressions of A20, HO-1 and Bcl-X(L) localized mainly in endothelial, smooth muscle, and infiltrating mononuclear cells. A20 expressed in grafts undergoing AR (5.04 +/- 0.71) and CR (3.20 +/- 0.64), not in NR grafts, and its expression in CR was weaker than that in AR ( P < 0.01). HO-1 expressed in AR (7.91 +/- 2.24), not in CR and NR. Bcl-X(L) was detected in all grafts (AR: 10.62 +/- 3.17; CR: 8.50 +/- 2.45; NR: 11.03 +/- 2.77), but had a decreased expression levels in CR. CONCLUSION: A20 and HO-1 may play protective role for AR, and A20 may be the essential protein having protective function for CR.
