ABSTRACT
We report the case of a 45-year-old man with a voluminous para-renal mass. The tumor was composed of epithelioid or spindle-shaped eosinophilic and clear cells with some atypia and an elevated mitotic count. The immunohistochemical study was positive for anti-HMB45 antibodies and anti-actin-antibodies and negative for epithelial markers and PS100 antibodies. The diagnosis of epithelioid AML (PEComa) was established. Two years later, recurrence was observed with a voluminous mass in the left upper quadrant of the abdomen, with high cellular density and the same immunohistochemical features. This tumor belongs to the PEComa and is not easy to diagnose clinically and morphologically. The immunohistochemical phenotype is characteristic. AML are usually benign but some epithelioid AMLS outcome can be unfavorable with metastatic dissemination. Criteria of malignancy are not clearly defined in the literature. This case shows that the mitotic count and the tumor size are probably important.
Subject(s)
Epithelioid Cells/pathology , Retroperitoneal Neoplasms/pathology , Soft Tissue Neoplasms/pathology , Actins/analysis , Antigens, Neoplasm , Biomarkers, Tumor/analysis , Diagnosis, Differential , Epithelioid Cells/chemistry , Humans , Kidney , Male , Melanoma-Specific Antigens , Middle Aged , Neoplasm Proteins/analysis , Neoplasm Recurrence, Local , Retroperitoneal Neoplasms/chemistry , Retroperitoneal Neoplasms/diagnosis , Retroperitoneal Neoplasms/surgery , Soft Tissue Neoplasms/chemistry , Soft Tissue Neoplasms/diagnosis , Soft Tissue Neoplasms/surgeryABSTRACT
BACKGROUND & AIMS: In Crohn's disease, cases of interstitial nephritis with renal failure have been reported in connection with the use of mesalamine. METHODS: We observed 4 patients with severe interstitial nephritis proven by examination of kidney biopsy specimens. Renal failure was discovered before or simultaneously with the diagnosis of Crohn's disease, and patients were not treated with mesalamine. Impairment of renal function progressed to end-stage renal failure in 3 of the 4 patients. RESULTS: Our results show that the kidney can be an extraintestinal target of Crohn's disease. CONCLUSIONS: Several unanswered questions remain concerning the frequency of interstitial nephritis in patients with Crohn's disease, as well as the exact role of mesalamine in the development of chronic interstitial nephritis.
