ABSTRACT
OBJECTIVES: Primary carcinoid tumor of the renal pelvis is a rare neoplasm with few cases reported in the literature. Here we present the clinical and histopathologic findings of a primary carcinoid tumor arising in the left renal pelvis of a horseshoe kidney in a 61-year-old female patient. MATERIALS AND METHODS: Pathologic features were evaluated with standard hematoxylin and eosin sections and immunohistochemical studies. A literature review was performed to place our case in context to previous reports. RESULTS: The tumor was associated with intestinal metaplasia with high-grade dysplasia and neuroendocrine hyperplasia. Molecular testing for microsatellite instability and loss of heterozygosity were negative. CONCLUSIONS: This report portrays a unique presentation of carcinoid tumor arising from intestinal metaplasia of the pelvic urothelium, and supports its histogenesis from urothelial intestinal metaplasia and neuroendocrine hyperplasia.
Subject(s)
Carcinoid Tumor , Kidney Neoplasms , Kidney Pelvis , Carcinoid Tumor/metabolism , Carcinoid Tumor/pathology , Female , Humans , Kidney Neoplasms/metabolism , Kidney Neoplasms/pathology , Kidney Pelvis/metabolism , Kidney Pelvis/pathology , Metaplasia , Middle AgedABSTRACT
Fluorescence in situ hybridization for abnormalities common to myelodysplastic syndrome (MDS FISH) is often used with traditional karyotype in the diagnosis and monitoring of myeloid neoplasms. However, its value in these roles has been questioned. To evaluate its utility, we compared MDS FISH results with karyotype in 544 bone marrow specimens obtained for diagnosis (180 cases) or follow-up (364 cases) of myeloid neoplasia. We found excellent concordance between FISH and karyotype, such that FISH is rarely abnormal (1.7% at diagnosis and 3.0% at follow-up) in cases with normal karyotype. Even in the rare discordant cases, the abnormal FISH has little or no clinical value. Thus, we propose that this test should be limited to cases with inadequate karyotype only. Such guidelines could result in significant cost savings with no impact on patient diagnosis.
Subject(s)
Chromosome Aberrations , Hematologic Neoplasms/genetics , Hematologic Neoplasms/pathology , In Situ Hybridization, Fluorescence , Myelodysplastic Syndromes/genetics , Myelodysplastic Syndromes/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Bone Marrow/pathology , Disease Progression , Female , Follow-Up Studies , Hematologic Neoplasms/diagnosis , Humans , Karyotype , Karyotyping , Male , Middle Aged , Myelodysplastic Syndromes/diagnosis , Young AdultABSTRACT
Intracardiac thrombus is a condition of increasing clinical significance not only because of its potential complications but also because of the lack of clinical evidence to guide clinicians in selecting optimal therapies. Thus, 2 recent cases encountered at the Vanderbilt University Medical Center illustrate the clinical challenges one may encounter in patients with intracardiac thrombus. A careful review of the diagnostic challenges, potential complications and current recommendations for management are presented.
