ABSTRACT
We report a case of renal metastases from prostate cancer to show that the possibility of tumor metastasis, although rare, should always be considered in the differential diagnosis of renal mass.
Subject(s)
Adenocarcinoma/secondary , Kidney Neoplasms/secondary , Prostatic Neoplasms/pathology , Adenocarcinoma/diagnosis , Aged , Carcinoma, Renal Cell/diagnosis , Diagnosis, Differential , Humans , Kidney Neoplasms/diagnosis , MaleABSTRACT
Isolated necrotizing arteritis (INA) of the polyarteritis-nodosa type localized to the female genital tract is rare. Approximately 30 case reports have been published to date. Eleven additional patients are described here, all with a favorable follow-up. INA is usually localized in the uterine cervix, but, when multifocal lesions are present, the latter is almost always involved. Patients most frequently report menorrhagia or postmenopausal bleeding. With immunohistochemical studies, immune-complex deposits (IgM, IgG, and C'3) in 7 of 11 patients with INA of the female genital tract were demonstrated for the first time. The inflammatory cells were composed mainly of T-lymphocytes with macrophages and scarce B-lymphocytes also present. These results suggest that INA is primarily an immune complex-mediated disease, implicating humoral and cellular mediator systems. Possible pathogenetic factors of INA are immune complex-mediated hypersensitivity reactions to drugs, foreign materials (after cone biopsy or curettage), and cancers, or an autoimmune reaction against constituents of the vessel walls caused by tissue injury after local surgical intervention through in situ immune-complex formation.
Subject(s)
Genital Diseases, Female/pathology , Polyarteritis Nodosa/pathology , Adult , Aged , B-Lymphocytes/cytology , Female , Fibrinogen/metabolism , Genital Diseases, Female/immunology , Genital Diseases, Female/metabolism , Humans , Immunoenzyme Techniques , Immunoglobulins/analysis , Immunophenotyping , Macrophages/cytology , Middle Aged , Polyarteritis Nodosa/immunology , Polyarteritis Nodosa/metabolism , T-Lymphocytes/cytologySubject(s)
Granuloma, Foreign-Body/pathology , Pyelonephritis/pathology , Tuberculosis/diagnosis , Adult , Calcium Oxalate/analysis , Diagnosis, Differential , Female , Granuloma, Foreign-Body/etiology , Granuloma, Giant Cell/etiology , Granuloma, Giant Cell/pathology , Humans , Kidney Calculi/diagnosis , Lithotripsy/adverse effectsABSTRACT
A sporadic case of multiple endocrine neoplasia type I with coexisting insulinoma and hyperparathyroidism was investigated in vivo and in vitro. The insulinoma was localized by somatostatin receptor scintigraphy and these receptors were functionally active. Octreotide administration decreased the basal insulin and glucagon secretion by 90 and 46%, respectively. Immunocytochemistry of the insulinoma tissue was positive for insulin, chromogranin A and neuropeptide Y. The insulinoma cells were also isolated and cultured in vitro. Incubation experiments revealed that a low glucose concentration (1 mmol/l) was sufficient to increase cytosolic free calcium and to produce a maximal glucose-induced insulin release. Northern blot analysis of RNA obtained from the tumor showed a high abundance of the low Km glucose transporter GLUT1 but no transcript for the high Km glucose transporter GLUT2. The abnormal distribution of glucose transporters probably relates to the abnormal glucose sensing of insulinoma cells, and explains their sustained insulin secretion at low glucose concentrations. Whether these abnormalities share a pathogenetic link with the presence of functionally active somatostatin receptors remains to be elucidated.