Primitive neuroectodermal tumors: Two genitourinary afflictions with varied presentations.

Primitive neuroectodermal tumor (PNET) is a rare disease with high malignant potential. It usually affects the skeletal system. Primary extraskeletal involvement of PNET is uncommon with few reported cases. PNET of the genitourinary system requires a very high index of suspicion for the diagnosis since the presentation of these tumors can be varied. We report two cases of PNET with varied presentations, affecting the genitourinary system.

Ureteropelvic junction obstruction - mimicking an "elephant head" on magnetic resonance imaging.

Ureteropelvic junction obstruction (UPJO) with giant hydronephrosis is relatively rare in adults as compared to children. Most of the UPJO reported or seen in daily practice have a distinct hydronephrosis with a narrow ureteropelvic junction and a collapsed ureter distally. We present images a case of an adult female with Left UPJO, which on MRI mimicked an 'elephant head'.

Can zero-hour cortical biopsy predict early graft outcomes after living donor renal transplantation?

INTRODUCTION: The aim of this study was to identify relevance of subclinical pathological findings in the kidneys of living donors and correlate these with early graft renal function. METHODS: This was a prospective study on 84 living donor kidney transplant recipients over a period of two years. In all the donors, cortical wedge biopsy was taken and sent for assessment of glomerular, mesangial, and tubule status. The graft function of patients with normal histology was compared with those of abnormal histological findings at one, three, and six months, and one year post-surgery. RESULTS: Most abnormal histological findings were of mild degree. Glomerulosclerosis (GS, 25%), interstitial fibrosis (IF, 13%), acute tubular necrosis (ATN 5%), and focal tubal atrophy (FTA, 5%) were the commonly observed pathological findings in zero-hour biopsies. Only those donors who had histological changes of IF and ATN showed progressive deterioration of renal function at one month, three months, six months, and one year post-transplantation. In donors with other histological changes, no significant effect on graft function was observed. CONCLUSIONS: Zero-hour cortical biopsy gave us an idea of the general status of the donor kidney and presence or absence of subclinical pathological lesions. A mild degree of subclinical and pathological findings on zero-hour biopsy did not affect early graft renal function in living donor kidney transplantation. Zero-hour cortical biopsy could also help in discriminating donor-derived lesions from de novo alterations in the kidney that could happen subsequently.

Contrast-induced nephropathy in urological imaging: A comparison with cardiology interventions.

INTRODUCTION: Published studies about contrast-induced nephropathy (CIN) mainly focus on cardiac intervention and rarely focus on patients undergoing urological contrast investigations. We aimed to determine the association and effect of intravenous (IV) iodinated contrast material on the incidence of CIN in a group of patients undergoing urology investigation and compare the results with that of cardiology interventions. METHODS: This prospective study was performed in patients undergoing IV contrast studies in Urology and those undergoing coronary interventions, in our institution for 1 year. Association between the occurrence of CIN and the risk factors such as age (≥60 years), sex, diabetes mellitus, hypertension, anemia, left ventricular ejection fraction <40%, estimated glomerular filtration rate (eGFR), and volume of contrast used were studied using Chi-square tests or Fisher exact test and Student's t-test. RESULTS: A total of 339 cases (168 urology and 171 cardiology) were studied. CIN was noted in 8.3% of urology patients whereas it was 29.8% in cardiology patients. In urology patients, statistically significant association was noted between CIN and eGFR <60 ml/min/1.73 m2 and volume of contrast used. In cardiology patients, statistically significant association (P < 0.05) was noted for diabetes, hypertension, eGFR <60 ml/min/1.73 m2, volume of contrast used. CONCLUSION: Although CIN was found to occur with contrast studies, the deleterious effects of contrast in urological procedures were lower than cardiology patients. The association between the occurrence of CIN and patient factors were also different in the two groups.