Digital ischemia and gangrene preceding renal neoplasm. An association with sarcomatoid adenocarcinoma of the kidney

1976 ◽  
Vol 136 (4) ◽  
pp. 486-488 ◽  
Author(s):  
R. H. Andrasch
Keyword(s):  
Renal Neoplasm ◽  
Digital Ischemia

scholarly journals Two Cases of Sporadic Eosinophilic Solid and Cystic Renal Cell Carcinoma in Manitoba Population

2021 ◽  
pp. 106689692199322
Author(s):  
Seyed Mohammad Mohaghegh Poor ◽  
Shivani Mathur ◽  
Karl Kassier ◽  
Janetta Rossouw ◽  
Robert Wightman ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Preoperative Imaging ◽  
Renal Neoplasm ◽  
Renal Masses ◽  
Cystic Renal Cell Carcinoma ◽  
Eosinophilic Cytoplasm ◽  
Clear Cell Rcc

Two sporadic cases of eosinophilic solid and cystic renal cell carcinoma (ESC RCC), at our institution, are presented in this study to contribute to the growing literature on this novel renal neoplasm. The first patient was a 38-year-old female with two synchronous renal masses measuring 3.5 and 1.9 cm on preoperative imaging. The second patient was a 44-year-old female with an incidental renal mass measuring 4 cm. Both patients underwent uncomplicated radical nephrectomies. The 1.9 cm mass in the first patient was consistent with clear cell RCC. The dominant mass in the first patient and the tumor in the second patient had microscopic and macroscopic findings in keeping with ESC RCC including a tan appearance, abundant eosinophilic cytoplasm, and CK20+ and CK7− staining. Both patients had an uncomplicated course following surgery with no evidence of local recurrence or distant metastatic disease for 1 and 2 years for the first and second patient accordingly. These cases contribute to a growing body of literature regarding ESC RCC including, to our knowledge, the first reported case of synchronous ESC RCC and clear cell RCC. Further research about this novel renal neoplasm is needed.

scholarly journals AB0440 CLINICAL AND IMMUNOLOGICAL FEATURES OF THE SYSTEMIC SCLEROSIS-OVERLAP SYNDROMES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1248.2-1248
Author(s):  
O. Desinova ◽  
M. Starovoytova ◽  
L. P. Ananyeva ◽  
O. Koneva ◽  
L. Garzanova ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Pathological Process ◽  
Point Of View ◽  
Joint Involvement ◽  
Laboratory Findings ◽  
Overlap Syndromes ◽  
Digital Ischemia ◽  
Immune Alterations ◽  
Clinical Variants

Background:Systemic Sclerosis (SSc) overlap syndromes (SSc with polymyositis / dermatomyositis (PM/DM), rheumatoid arthritis (RA), etc.) still remain a group of very heterogenous and not very well studied clinical variants of SSc that are characterized by certain clinical and immunological features.Objectives:Identify clinical and immunological features of the SSc-overlap syndromesMethods:80 pts with SSc-PM/DM and 35 pts with SSc-RA undergoing standard clinical examination and laboratory immunological evaluation.Results:ANA Hep2 was positive in 98% of SSc-PM/DM pts; a-Scl-70 was in 34%, a - PM-Scl and RF were in 20%. ACA (6%), a-RNP (9%), and a - Jo-1 (5%) were significantly less common. Correlation analysis showed significant prevalence of conduction abnormalities in pts with a-Scl-70- (p<0.03); PM-Scl was rarely associated with cardiac arrhythmia (p<0.02) and pericarditis (p<0.03), but there was an association between ACA and presence of digital ischemia (p<0.04). Three pts with limited skin had Scl-70 and PM-Scl antibodies, two of them manifested clinical features of DM. A-Jo-1 was found in 3 pts with a longstanding disease (14,10 and 7 years), and one of these pts was also positive for a-Scl-70. All pts had limited skin and two had interstitial lung disease with FVC values of 79% and 74.8%.ANA Hep2 was positive in 96% of SSc-RA pts; a-Scl-70 – in 28%, and a-RNP - in 30%. RF-positivity was in 72% of pts, and Anti-CCP - in 27%. Simultaneous Anti-CCP and a-Scl-70 was found in one case, and Anti-CCP - anti-RNP – in another, both were associated with low RF titers. All pts had early joint involvement which became prevailing in subsequent years, and onset of the disease between 30 and 36 years. There was a correlation between laboratory signs of inflammatory activity and immunological disorders: ESR and a-Scl-70 (p<0.03). Anti-CCP and a-Scl-70 co-positivity was a significantly less frequent phenomenon (p<0.04). There was a remarkable 28% proportion of a-Scl-70 cases in SSc-RA with limited cutaneous which is usually characterized by ACA-positivity.Conclusion:SSc-PM/DM and SSc-RA appear to be an active disease from the immunological point of view, confirming therefore an important role of immune alterations in disease progression. Laboratory findings display specific pathogenetic features of SSc-overlap syndromes; laboratory abnormalities can be used to measure the activity and specify characteristics of the pathological process.Disclosure of Interests:None declared

scholarly journals Renal angiomyoadenomatous tumor (RAT): a rare distinct entity with diagnostic challenges—a case report

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Ankur Majumder ◽  
Ravi Hari Phulware ◽  
Arvind Ahuja ◽  
Anurag Singla ◽  
Pawan Kumar
Keyword(s):  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Close Association ◽  
Good Prognosis ◽  
Renal Tumors ◽  
Team Approach ◽  
Renal Neoplasm ◽  
Presenting Symptoms ◽  
Long Term Follow Up

Abstract Background Renal angiomyoadenomatous tumor (RAT) is a recently described rare renal neoplasm with variations in the presentation, gross, and microscopic findings, and having a benign course and good prognosis. It is characterized microscopically by the admixture of three components—epithelial cells arranged in tubules and nests, angiomyomatous stroma, and capillary-sized interconnecting vascular channels in close association with the epithelial cell clusters. Microscopically, these tumors can be confused with clear cell carcinoma, papillary carcinoma, mixed epithelial and stromal tumors, and angiomyolipoma. RAT differs from conventional clear cell carcinomas, which can rarely be associated with an identical leiomyomatosis stroma occasionally forming abortive vascular structures. RAT is a distinct morphologic entity, being different morphologically, immunohistochemically, and genetically from all renal tumors including conventional clear cell carcinoma and mixed epithelial and stromal tumor of the kidney. Case presentation Here, we report a case of a 21-year-old man with renal angiomyoadenomatous tumor, a rare neoplasm with only a few previous cases reported in the literature. Unlike our case, most tumors have been identified in middle-aged males; they present as well-circumscribed, encapsulated tan-brown masses with variably prominent cystic areas. Conclusion Diagnosis of RAT is challenging because of the rarity of the disease and common presenting symptoms to other renal pathology and is supplemented with histopathology and immunohistochemistry. A multidisciplinary team approach for diagnosis and management along with long-term follow-up are warranted.

scholarly journals Non-target digital ischemia in an ulnar artery distribution following transradial access: Case report and review of best practice techniques

2021 ◽  
pp. 112972982110008
Author(s):  
Patrick Kennedy ◽  
Darren Klass ◽  
John Chung
Keyword(s):  
Best Practice ◽  
Artery Aneurysm ◽  
Ulnar Artery ◽  
Complication Rates ◽  
Endovascular Interventions ◽  
Transradial Access ◽  
Digital Ischemia ◽  
Aneurysm Embolization ◽  
Lower Complication ◽  
Access Complications

Transradial access is a safe approach for visceral endovascular interventions, with lower complication rates compared to transfemoral access. This report describes an unusual case of ulnar artery thrombosis following splenic artery aneurysm embolization via left transradial approach, resulting in non-target digital ischemia and eventual amputation of the ring and little finger distal phalanges. Technical considerations to reduce the incidence of access complications are also reviewed, along with practice modifications undertaken at our institution following this case to improve outcomes.

Intravascular Papillary Endothelial Hyperplasia of Renal Vein: Report of 2 Cases

2005 ◽  
Vol 129 (4) ◽  
pp. 516-519
Author(s):  
Mohammed Akhtar ◽  
Muhammed Aslam ◽  
Hadeel Al-Mana ◽  
Hana Bamefleh ◽  
Sultan S. Al-Khateeb ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Renal Vein ◽  
Renal Mass ◽  
Malignant Neoplasms ◽  
Renal Neoplasm ◽  
Intravascular Papillary Endothelial Hyperplasia ◽  
Process Thought ◽  
Papillary Endothelial Hyperplasia ◽  
Hilar Region ◽  
Characteristic Features

Abstract Intravascular papillary endothelial hyperplasia is a benign intravascular process thought to arise from an organizing thrombus. The lesion may present clinically as an abnormal mass and, depending on the location, may be confused with benign or malignant neoplasms. It has been described in a variety of locations. Involvement of the renal vein by papillary endothelial hyperplasia is extremely rare, with only 4 cases reported in the literature. We describe 2 additional cases. In both cases, the radiologic examination revealed a well-circumscribed mass in the hilar region of the kidney, which was considered to be a renal neoplasm. Nephrectomy specimen in each case revealed characteristic features of intravascular papillary endothelial hyperplasia. It is suggested that intravascular papillary endothelial hyperplasia should be included in the differential diagnosis of a hilar renal mass.

scholarly journals Association between R.E.N.A.L nephrometry score and perioperative outcomes following open partial nephrectomy under cold ischemia

2014 ◽  
Vol 8 (3-4) ◽  
pp. 137
Author(s):  
Dong Soo Park ◽  
Jin Ho Hwang ◽  
Moon Hyung Kang ◽  
Jong Jin Oh
Keyword(s):  
Blood Loss ◽  
Partial Nephrectomy ◽  
Perioperative Outcomes ◽  
Renal Neoplasm ◽  
Cold Ischemia ◽  
Ischemic Time ◽  
Open Partial Nephrectomy ◽  
Cold Ischemic Time ◽  
Nephrometry Score ◽  
Estimated Blood Loss

Introduction: We investigate the clinical significance of the R.E.N.A.L. nephrometry score for renal neoplasm following open partial nephrectomy (PN) under cold ischemia.Methods: A retrospective analysis was conducted using clinical data of 98 consecutive patients with clear cell renal cell carcinoma who underwent open PN by a single surgeon from December 2000 to September 2012. Tumour complexity was stratified into 3 categories: low (4-6), moderate (7-9) and high (10-12) complexity. Perioperative outcomes, such as complications, cold ischemic time, estimated blood loss and renal function, were analyzed according to the complexity by NS. Complications were stratified using the Clavien-Dindo classification system.Results: Tumour complexity according to nephrometry score was assessed as low in 16 (16.3%), moderate in 48 (49.0%) and high in 34 (34.7%). The median cold ischemic time did not differ significantly among the 3 groups (36.0 minutes in low-, 40 minutes in moderate- and 43 minutes in the high-complexity group, p = 0.421). Total complications did not differ significantly (2 (2.0%) in low, 4 (4.1%) in moderate and 4 (4.1%) in high, p = 0.984). Each Grade 3 complication occurred in the moderate (urine leakage) and high groups (lymphocele). Postoperative renal functional outcomes were similar among the groups (p = 0.729). Only mean estimated blood loss was significantly different with nephrometry score (p = 0.049).Conclusions: The nephrometry score, as used in an open PN series under cold ischemia, was not significantly associated with perioperative outcomes (i.e., ischemia time, complications, renal functional preservation).

Fibromuscular Dysplasia of Distal Radial and Ulnar Arteries: Uncommon Cause of Digital Ischemia

1994 ◽  
Vol 33 (6) ◽  
pp. 652-655 ◽  
Author(s):  
Vijay P. Khatri ◽  
J Claude Gaulin ◽  
Atul K. Amin
Keyword(s):  
Fibromuscular Dysplasia ◽  
Digital Ischemia
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