Primitive neuroectodermal tumor of the kidney is a rare tumor. A total of approximately 79 primary renal cases have been reported to date. Primitive neuroectodermal tumors occur preferentially in the soft-tissues of the paravertebral region and chest wall, less frequently in extremities, with a slight male predominance. We report a case of primitive neuroectodermal tumor of the kidney in a 17-year-old male with a pre-operative diagnosis of renal cell carcinoma-stage 4. The patient underwent radical nephrectomy and histopathological examination revealed a highly aggressive tumor of monotonous sheets of round cells with focal areas of rosette formations and high mitotic rate with Ki67 index of 25-30%. Tumor cells were positive for CD 99 confirming the diagnosis of primitive neuroectodermal tumor. Primitive neuroectodermal tumor of the kidney needs to be kept in mind as a differential diagnosis in young adults presenting with a large kidney mass.
Endometrial thermal balloon ablation is a recent technique for treatment of dysfunctional uterine bleeding. Although the histologic features of thermal injury to the endometrium have been documented, the cytologic features are not described in the literature. In this study, the cytomorphology of recent thermal injury was studied and correlated with histomorphology.The study consisted of 29 cases divided into 3 groups: (1) control group, hysterectomies without ablation; (2) specimen (in vitro) group, where ablation was carried out on the uteri in the immediate postoperative period; and (3) in vivo group, with intraoperative endometrial ablation. The cytotoxic effect of thermal injury was assessed by staining the smears for oxidative enzymes.The cytomorphologic features of in vivo thermal ablation were characteristic and composed of fragmented glands, numerous single cells with fuzzy cytoplasm and giant cells. Staining for dehydrogenases was absent from > 90% of endometrial cells in the in vivo cases as against 100% positivity in the control group.The cytomorphologic features described for the first time in this study can be applied to endometrial aspirate or brush smears to evaluate the efficacy of the technique and follow-up.
Abstract Background Mycobacterial isolation from cutaneous tuberculosis on Löwenstein–Jensen (L–J) medium has been reported to be low. The radiometric BACTEC 460 TB culture system (BACTEC system) has shown better isolation rates in pulmonary tuberculosis. There has been a progressive increase in the prevalence of multidrug resistance in pulmonary tuberculosis, but similar studies are lacking for cutaneous tuberculosis. Therefore, this study was undertaken to compare mycobacterial isolation on conventional L–J medium vs. the BACTEC system, and to determine the prevalence of multidrug resistance in cutaneous tuberculosis. Methods Thirty‐five untreated, clinically diagnosed, and histopathologically documented patients with cutaneous tuberculosis constituted the study material. Lesional skin biopsy specimens were cultured on both L–J medium and the BACTEC system. The isolates obtained were identified and subjected to sensitivity to rifampicin, isoniazid, ethambutol, and streptomycin using the BACTEC system. Results Twenty‐six mycobacterial isolates were recovered from 35 patients. Nine isolates (25.7%) grew on L–J medium after a mean period of 31.5 days, and 22 (62.8%) on the BACTEC system in 17.3 days. All of the isolates were identified as Mycobacterium tuberculosis . Drug susceptibility testing demonstrated 12 isolates to be resistant, seven multidrug resistant. Discussion The BACTEC system demonstrated an improved mycobacterial isolation rate and substantially reduced detection time when compared with L–J medium. The combined isolation rate on both media was 74.3% (26/35), greater than that of either used separately. Drug resistance was observed in 46.2% of isolates. Conclusion Radiometric liquid culture medium together with conventional L–J medium may be recommended in practice to enable the institution of appropriate antituberculous therapy modifications in drug‐resistant cases of cutaneous tuberculosis.
Primitive neuroectodermal tumour of chest wall has been given the name Askin tumour after FB Askin who first reported this distinctive clinicopathologic entity in 1979. Most of the patients are either children or adolescents, however, rarely it may affect older patients. This case report emphasizes on the diagnostic approach to this rare tumour and underlines the importance of keeping it in the differential diagnosis even in elderly patients. Since it is an aggressive tumour, a high index of suspicion is required to make a timely diagnosis.
Although Wilms' tumor (WT) is the most common pediatric solid renal tumor accounting for 6–7% of all childhood cancers, there are many other rare renal neoplasms which may mimic its presentation. These tumors collectively account for 10–15% of all primary renal neoplasms of childhood and are grouped together as non-Wilms' renal tumors (NWRT). They are heterogeneous and include a wide spectrum of benign and malignant tumors with varying biological behavior, malignant potential, and prognosis. Congenital mesoblastic nephroma (CMN), clear-cell sarcoma of the kidney (CCSK), and malignant rhabdoid tumor of the kidney (MRTK) are some of the frequently reported types, while multilocular cystic renal tumors, renal cell carcinoma (RCC), angiomyolipoma, renal medullary carcinoma, metanephric adenoma, ossifying renal tumor of infancy, primitive neuroectodermal tumor, and lymphoma are some of the uncommon NWRT of childhood. The biological and clinical behavior of this group of tumors is poorly understood due to their heterogeneity and rarity. The learning objectives of this chapter are to know the salient clinical, radiological, and histopathological features of these tumors to minimize diagnostic uncertainties and accurate differentiation from WT. This review also emphasizes the differences in management protocols especially chemotherapeutic regimens between WT and NWRT. Risk stratification of these tumors based on genetic profiling and the recent advances in their management are also discussed.
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