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HOW GLOMERULAR EXTRACAPILLARY PROLOFERATION MIGHT LEAD TO LOSS OF RENAL FUNCTION: LIGHT MICROSCOPIC AND IMMUNOHISTOCHEMICAL INVESTIGATION
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Pregnancy-related decidualization of subcutaneous endometriosis occurring in a post-caesarean section scar: Case study and review of the literature
No full textEndometriosis of surgical scars is a rare complication of caesarean sections (incidence: 0.03-0.4%) and other surgical procedures. As endometriosis could be responsive to hormonal stimulation, decidualization and other secondary changes may occur during pregnancy or progestin therapy, sometimes causing a clinically-evident increase in the size of the endometriotic nodules, which could be mistaken for malignant tumors. To our knowledge, we report the 8th subcutaneous case of a pregnancy-related decidualization occurring in a post-caesarean section scar endometriosis. A 33-year-old woman showed a painless, firm, subcutaneous nodule (size: 1 cm) located near the scar of a caesarean section performed 3 years before. Ultrasound examination revealed a well-delimited, hypoechogenic nodule showing perilesional inflammatory reaction without vascular signals. The nodule was considered a post-surgical granuloma: its size did not increase during 4 years of follow-up. Finally, the nodule was totally excised during a second caesarean section performed at 39 weeks of gestation. Histological examination showed nodules of decidualized stromal cells surrounding rare, small, atrophic endometrial glands. Nuclear atypia and mitoses were absent. On immunohistochemical examination, the epithelial cells were pan-CK(AE1/AE3)+/ER+/PR+/S100-/Calretinin-/Vimentin-, while the stromal cells were pan-CK(AE1/AE3)-/Vimentin+/ER+/PR+/CD10+/S100-/Calretinin-. We reviewed the literature, discussing the main clinic-pathological diagnostic pitfalls and the possible differential diagnoses
The prognostic value of renal biopsy in type 2 diabetes mellitus patients affected by diabetic glomerulosclerosis
No full textPrimitive Neuroectodermal Tumor of the Meninges: An Histological, Immunohistochemical, Ultrastructural, and Cytogenetic Study
No full textKidney and urinary tract polyomavirus infection and distribution: molecular biology investigation of 10 consecutive autopsies
No full textCONTEXT:
Distinct human polyomavirus genotypes cause different diseases in patients with renal transplants: BK virus (BKV) causes tubulointerstitial nephritis and ureteral stenosis, whereas both JC virus (JCV) and BKV are responsible for hemorrhagic cystitis. These findings could result from a selective infection of kidney and urinary tract segments by JCV or BKV.
OBJECTIVE:
To verify this hypothesis, 10 complete, unselected, consecutive autopsies from 9 immunocompetent patients and 1 patient affected by acquired immunodeficiency syndrome were investigated.
DESIGN:
Samples from kidneys (n = 80), renal pelvis (n = 20), ureter (n = 40), and urinary bladder (n = 30) obtained from 10 consecutive autopsies were investigated by means of multiplex nested polymerase chain reaction to detect polyomavirus DNA and to distinguish different species of the Polyomavirus genus. In situ hybridization and immunohistochemistry were also carried out to define the viral status of the infected tissues.
RESULTS:
Polyomavirus DNA was detected in all of the subjects (positive samples ranging from 2 to 7 samples), for a total of 43 of 170 samples (25.3%), distributed as follows: urinary bladder (10/30, 33%), renal pelvis (6/20, 30%), ureter (10/40, 25%), and kidney tissue (17/80, 21%). We found that JCV was most frequently detected overall (23/43 samples, 53.5%) and was also detected most frequently within the kidney (8/17 positive samples, 47%), the renal pelvis (5/6 positive samples, 70%), and the ureter (7/10 positive samples, 70%), whereas BKV was found in 14 samples (32.5%), and it was the prevailing genotype in urinary bladder (6/10 positive samples, 60%). Coinfection of BKV-JCV was found in 6 samples (14%). Immunohistochemistry and in situ hybridization returned negative results.
CONCLUSIONS:
The viruses JCV and BKV latently persist randomly in kidney and urinary tract. Distinct diseases induced by them could be related more closely to molecular viral rearrangements than to the topographic distribution of latent viruses
SEVERE CRESCENTIC BK VIRUS NEPHROPATHY WITH FAVOURABLE OUTCOME IN A TRANSPLANTED PATIENT TREATED WITH LEFLUNOMIDE
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