A 12-year-old dog was evaluated for depression and anorexia. The results of complete blood count and serum biochemistry were normal. Survey radiographs revealed markedly enlarged right kidney and abdominal ultrasound showed a renomegaly and hydronephrosis filled with mixed echogenic fluid. Primary renal tumor was suspected in this dog. Nephroureterectomy of the right kidney was performed, and no regional metastases have been identified. Transitional cell carcinoma (TCC) arising from renal pelvis accompanied hydronephrosis of the right kidney was diagnosed on histology. TCC usually affects trigone of the bladder, and renal origin of TCC is a very rare finding in dogs. This is the first case report to present the clinical features, diagnostic imaging findings and histopathological characteristics of a dog with TCC originating from the renal pelvis in Korea.
Purpose: Most of diagnosis in the pediatric hydronephrosis patients have been performed $^{99m}Tc$-DMSA renal scan. Then the region of interest (ROI) is set for comparative analysis of uptake ratio in left-right kidney after acquiring the image. But if the equipment set an automatic ROI, the ROI could include expanded renal pelvis due to hydronephrosis and the uptake ratio of left-right kidney will be incorrect result. Therefore this study compared both ROIs including expanded renal pelvis and excluding renal pelvis through experiment using normal kidney phantom and expanded renal pelvis phantom and suggested setting method of improved ROI. In addition, this study have been helped by readout doctor for investigate distinction radiopharmaceutical uptake between renal cortex and remained urine by expanded renal pelvis. Materials and Methods: The both of renal phantoms were filled with water and shacked with $^{99m}TcO_4$ 111 MBq. In order to describe the expanded renal pelvis, the five latex balloon were all filled with 10 mL water and each of balloon was mixed with $^{99m}TcO_4$ 18.5, 37, 55.5, 74, 92.5 MBq. And we made phantom with fixed $^{99m}TcO_4$activity of 37 MBq and mixed water 5, 10, 15, 20, 25 mL in each balloon. The left kidney was fixed its shape and the right kidney was modified like as hydronephrosis kidney by attached the latex balloons. And the acquiring counts were 2 million. After acquisition, we compared the image of ROI with Expanded renal pelvis and the image of ROI without renal pelvis for analyzing difference in the uptake ratio of left-right kidney and for reproducibility, set the ROI 5 times in the same images. Patients were injected $^{99m}Tc$-DMSA 1.5~1.9 MBq/kg and scanned 3 to 4 hours after injection. The each of 3 skillful radio technologists performed the comparing estimation by setting ROI. To determine statistical significance between two data, SPSS (ver. 17) Wilcoxon Signed Ranks Test was used. Results: As a result of renal phantom's experiment, we compared with average of counts Background (BKG) ratios in the setting of ROI including expanded renal pelvis and setting of excluding expanded renal pelvis. Therefore, they can obtain changed counts and changed ratios. Patient also can obtain same results. In addition, the radiopharmaceutical uptake in expanded renal pelvis was come out the remained urine that couldn't descend to ureter by the help of readout doctor. Conclusion: As above results, the case of setting ROI including expanded renal pelvis was more abnormally increasing uptake ratio than the case of setting ROI excluding expanded renal pelvis in analysis the uptake ratio in left-right kidney of hydronephrosis. Because of the work convenience and prompted analysis, the automatic ROI is generally used. But in case of the hydronephrosis study, we should set the manual ROI without expanded renal pelvis for an accurate observation of the uptake ratio of left-right kidney since the radiopharmaceutical uptake in expanded renal pelvis is the remained urine.
Yuri Seu;Hyun Jin Park;Jin Seo Park;Yong-Suk Moon;Hongtae Kim;Mi-Sun Hur
Anatomy and Cell Biology
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v.57
no.3
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pp.476-480
/
2024
Present case report describes a case of bifid ureter arising directly from separate calyces and renal pelvis of the kidney. Incomplete ureter duplication on the left side in a 78-year-old male cadaver was found during an anatomy class. These ureters converged in a Y-shaped pattern just above the level of the anterior superior iliac spine. In the coronal section of the kidney, the anterior ureter arose from a renal pelvis that was divided into two major calyces in the lower two-thirds of the kidney. On the other hand, the posterior ureter was directly connected to a major calyx in the upper third of the kidney, without the formation of a renal pelvis. This anatomical variation has implications for diagnostic approaches, especially in the use of imaging techniques by urologists for the insertion of stents in the treatment of phyelonephritis.
Anatomical features of the renal papilla and pelvis and ultrastructures of the epithelium covering these areas in four species of mammals were studied by means of light, scanning and transmission electron microscopy. In terms of the morphology of mammalian kidney types distinguished by Sperber(1944), Pfeiffer(1968) and Schmidt-Nielsen(1977), the kidneys of animal species used in this experiment were; 1) the mouse kidney with the fornix between a long conical papilla and the funnel-shaped pelvis, 2) the guinea pig kidney with the peripelvic column and pelvic pouch between a short conical papilla and the funnel-shaped pelvis, 3) the dog kidney with the peripelvic column and pelvic pouch between the crest-shaped papilla and the funnel-shaped pelvis, and 4) the cattle kidney which is divided into multiple renculi with minor and major calyces and pelvis. The renal papilla was lined with the simple or pseudostratified columnar epithelium which covered the inner zone of the renal medulla. The epithelial cells with numerous short microvilli on the surface contained a few organelles. In the mouse, the fornix was lined with one to two cell-layered cuboidal epithelium which covered the outer zone of the renal medulla and a part of the cortex. The epithelial cells of the fornix with numerous short microvilli or microridges on the surface had well-developed organelles. In the guinea pig, the peripelvic column was lined with the simple cuboidal or low columnar epithelium which covered the outer zone of the renal medulla. The epithelial cells with numerous short microvilli on the surface contained well-developed organelles. The pelvic pouch was lined with the pseudostratified columnar epithelium which was composed of four kinds of cells; the secretory cell with small electron-dense granules (310 nm), the secretory cell with large granules (720 nm) showing various electron densities, the mitochondria-rich cell with a single cilium, and the basal cell. Pelves of the mouse and guinea pig, peripelvic column, pelvic pouch and pelvis of the dog, and minor and major calyces and pelvis of the cattle were lined with the transitional epithelium. The fusiform vesicles in the superficial cells of the epithelium were highly developed in the dog, relatively well developed in the mouse and guinea pig, and poorly developed in the cattle. From the above findings, it is suggested that the transport of solutes and water of the urine in the pelvic cavity can take place through the epithelia covering the renal papilla and fornix of the mouse, papilla and peripelvic column of the guinea pig, and papillae of the dog and the cattle. And specialized cell types in the epithelium of the guinea pig pelvic pouch, two kinds of secretory cells and mitochondria-rich cell with a single cilium, could have peculiar functions in the renal pelvis, respectively.
2 Cases of nephrotomy for removal of calculi in dog were referred to veterinary teaching hospital of Konkuk University. In case 1, a 5 year-old, castrated male Yorkshire Terrier dog was referred because of intermittent hematuria, pain in urination for one month. Hematologic and chemical examination showed mild increased BUN and CPK. Radiographic findings revealed radiopaque materials in the urinary bladder, urethra, and left kidney. Retrograde hydropropulsion was performed to move the calculi into the bladder, and cystotomy was done to remove calculi. Nephrotomy was performed to removal of the calculi from the left renal pelvis and calyx. After operation renal function were recovered and preserved. In case 2, a 5 year-old, neutral female Schnauzer dog was referred because of persistant vomiting, anorexia, and celialgia for 20 days. Hematologic and chemical examination showed stress leucogram, moderate azotemia, hypercalcemia, hyperphosphatemia, and increased ALP. Radiographic findings revealed enlargement of the left kidney and radiopaque materials in the both of the kidneys. On excretory urography, left kidney was no pyelogram. On ultrasonography, renal tissue was very thin and distended renal pelvis appeared. Nephrectomy of nonfunctional left kidney and nephrotomy for removal of calculi from the right renal pelvis and calyx were done. One week after operation, renal and hepatic functions were recovered. So, in cases of renal calculi, it is necessary that renal calculi are extracted actively as far as the patient's body condition endurable.
Urine cytology is of limited value in the diagnosis of renal cell carcinoma with reported detection rates of $0\sim80%$. The aim of this study is to demonstrate the usefulness of urine cytology in renal cell carcinoma. In the eleven histologically proven cases of renal cell carcinoma, urinary smears were reevaluated. The cytologic results were as follows; positive for malignant cells in 3 cases(27%), suspicious in 2 cases(18%) and negative in 6 cases(55%). The average diameter of the tumor of the 5 cases reported as positive or suspicious for malignant cells was 9.7cm and 3 had invaded the renal pelvis. The other 6 tumors, reported as negative, were 5.7 cm in average diameter and one of them showed involvement of the renal pelvis. These results suggest that urine cytology is considered unsatisfactory in the early defection of renal cell carcinoma. However, careful examination of urinary smear could improve the detection rate especially in more advanced cases involving the renal pelvis as well as those of larger tumors.
Satheesha B Nayak;Narendra Pamidi;Vasanthakumar Packirisamy;Soumya Kodimajalu Vasudeva
Anatomy and Cell Biology
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v.56
no.1
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pp.141-144
/
2023
Knowledge of variations of renal vessels is of utmost importance in retroperitoneal surgeries and kidney transplant surgeries. We report concurrent variations of the right renal vessels, observed in an adult male cadaver during dissection classes. The right kidney was supplied by three renal arteries, out of which two entered the kidney through the hilum and the other one entered through the lower pole of the kidney. There were five renal veins, emerging independently from the hilum and opening separately through five openings into the inferior vena cava. Among the veins, only one emerged anterior to the renal pelvis and the other four emerged behind it. Four of them terminated into the posterolateral aspect of the inferior vena cava, whereas one terminated into its anterior aspect. Fourth vein from above, received the right testicular vein. The renal hilum was clogged with the presence of seven vessels and renal pelvis.
This study was performed to clarify the morphological structures of the epithelia of the renal papilla, renal pelvis and ureter of the sheep (Ovis aries L.) through the light and scanning electron microscopes, Tissue specimens were taken from the renal papilla (common renal papilla and peripelvic column) and the renal pelvis (pelvis proper and pelvic pouch) of the kidney and the ureter. For the light microscopy, tissue blocks were fixed in 10 % neutral buffered formalin and embedded in paraffin wax, serially sectioned at a thickness of $6{\mu}m$. These sections were stained with hematoxylin-eosin and periodic acid-Schiff reaction. For the scanning electron microscopy, tissue blocks were prefixed in 1% glutaral-dehyde-1.5% paraformaldehyde solution and postfixed in 1% osmium tetroxide solution, dehydrated in graded alcohol, transferred to isoamyl acetate, and then dried by the critical point dryer (Polaron E 3000). These dried tissues were coated with gold and observed with a scanning electron microscope (JSM-35C), The results were as follows: The apex of the common renal papilla was lined with simple columnar epithelium having many microvilli on its luminal surface. Lateral portion of the papilla was lined with stratified epithelium $2{\sim}3$ layers thick, and its superficial cells were microvillar cells having many microvilli. The epithelium lining the peripelvic column was $1{\sim}2$ layers thick. The superficial layer was made of the microvillar cells, but a few microplica cells were appeared in the region near the pelvic pouch. The epithelium of the pelvic pouch was $1{\sim}2$ layered transitional type, and its superficial cells were microplica cells. The epithelia of the pelvis proper and ureter were $4{\sim}6$ layered transitional type, and their superficial cells were typical facet cells existing many round depressions and ridges of cell membranes of the luminal side.
A 9-year-old, male, Doberman pinscher dog with 5-month history of intermittent hematuria, vomiting and glucosuria was referred to local animal hospital. Abdominal ultrasonography showed an irregular and hyperechoic mass in the renal medulla of the enlarged left kidney. Grossly atrophied renal cortex and medulla and marked hydronephrosis were observed on the cut surface of kidney. A single, numerous papillary projected, pedunculated mass 4~5.5 cm in diameter was occupied in renal pelvis, and extended from pelvis to the inlet of ureter. Histopathologically, the mass had numerous papillary structures with arboriform pattern. These papillae were consisted of fibro-vascular stalks that were lined by multiple layers of neoplastic urothelium (transitional epithelium) with marked cellular atypia. Immnohistochemical (IHC) staining demonstrated that the neoplastic cells showed strong positive reactions for cytokeratin (CK) 7, CK 19, CK clone MNF116 and CK high molecular weight, but negative signals for CK 8 low molecular weight. Based on the gross findings, histopathology and CKs profile using IHC staining, this mass was diagnosed as renal pelvis transitional cell carcinoma in a dog.
Kim, Maru;Kim, Joongsuck;Kim, Sung Jeep;Cho, Hang Joo
Journal of Trauma and Injury
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v.30
no.2
/
pp.47-50
/
2017
A 21-year-old male visited our emergency room. He could not remember the mechanism of injury. He was found beside a motorcycle. Initial vital sign was stable. Observation and conservative treatment were planned at the intensive care unit (ICU). On the third day at ICU, he complained sudden flank pain. It was colicky and hard to control. Without the pain, he had no specific symptom, sign, or laboratory findings. On computed tomography, renal pelvis was filled with hematoma which induced hydronephrosis. Double-J catheter and percutaneous nephrostomy was implemented by an intervention radiologist. Hematome in the renal pelvis was aspirated during the procedure. Symptom of the patient was subsided after the procedure. He was discharged without specific complications.
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