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Clear Cell Sarcoma of the Kidney CCSK

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Clear Cell Sarcoma of the Kidney CCSK Powered By Docstoc
					 CPC #3
Pathology
        Radical Nephrectomy
• Three intrarenal masses with cystic change
  (9, 7, and 5cm)
• Nodular Mass (3cm) in perirenal fat
     Not all Renal Tumors (Masses)
       are Renal Cell Carcinoma!
•   Angiomyolipoma
•   Oncocytoma
•   Xanthogranulomatous Pyelonephritis
•   Malakoplakia
•   Adrenal Rest
Xanthogranulomatous Pyelonephritis

• Subacute/chronic inflammation forming a
  mass lesion in the kidney
• Tender unilateral flank mass
• Nephrolithiasis (70%)
  – Long term recurrent obstruction
• Adults
• Female Predominance (2:1)
Xanthogranulomatous Pyelonephritis
• Gross:
  – yellow mass often extending into perirenal fat,
    mimicking renal cell carcinoma
• Microscopic:
  –   Lipid-laden macrophages
  –   Fibroblastic proliferation
  –   Lymphocytes, plasma cells
  –   Microabscesses
• Microbiology:
  – Often Proteus mirabilis, E. Coli
CD68
          Diagnosis
Xanthogranulomatous Pyelonephritis
ACID-FAST STAIN
ACID-FAST STAIN
               Diagnosis
• Xanthogranulomatous Pyelonephritis
• Numerous Acid-fast Bacilli
     Similar Cases in Literature
• Shah HN et al. Renal tuberculosis simulating
  xanthogranulomatous pyelonephritis with
  contagious hepatic involvement. Int J Urology
  2006;13: 67-68.
• Izbudak-Oznur et al. Renal tuberculosis
  mimicking xanthogranulomatous pyelonephritis:
  ultrasonography, computed tomography and
  magnetic resonance imaging findings. Turk J
  Pediatr 2002;44: 168-171
           Important Point
• Immunocompromised patients often do not
  form granulomas well
• One may see Mycobacterial or Fungal
  Infections without well-formed granulomas

				
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posted:7/26/2011
language:English
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