1981 Volume 72 Issue 10 Pages 1343-1349
A case of transitional cell carcinoma in a pyelocalyceal diverticulum is presented. A 42-year-old man, NHH 1008757, was hospitalized with asymptomatic hematuria. Cystoscopically, a left renal bleeding was noticed. The routine laboratory data, the chest X-ray and repeated urine cytology were normal or negative. Radiographically an excretory urogram (IVP) revealed a compression of the calyces and pelvis of the left kidney. A renal angiogram revealed the avascular mass measuring ca. 8 by 8cm. Although retrograde pyelography could not reveal any communication with the calyx immediately, computed axial tomography done thereafter demonstrated contrast medium staying in the cavity of the cystic lesion. However, puncture of the cavity was attempted under the CT scanning without success. The inner aspect of the wall showed irregularity.
On exploration of the kidney, the inner aspect of the cystic cavity was warty. Radical nephroureterectomy was performed, since the biopsy of the wall demonstrated transitional cell carcinoma on the frozen section.
Grossly a large cyst, measuring 8 by 8cm, occupied the middle portion of the left kidney but no apparent connection between the calyceal system and the cyst was identified.
Microscopically, the wall of the cavity was covered with mixture of nearly normal transitional cell epithelium and transitional cell carcinoma of grade II and grade III. Therefore, we concluded that the clinicopathological diagnosis is a case of transitional cell carcinoma developed in the calyceal diverticulum of the left kidney.
To our knowledge, this is the first case of transitional cell carcinoma in pyelocalyceal diverticulum in Japan.
