Renal Pelviceal Keratinizing Squamous Metaplasia with Sparing of Pyramidal Zones
Metaplastic changes in the urothelium of the upper urinary tract are relatively infrequent. Metaplasia may present as either squamous or less often glandular differentiation. The process may be associated with chronic inflammation or associated chronic infections. There may be malignant transformati...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Case Reports in Urology |
| Online Access: | http://dx.doi.org/10.1155/2012/242780 |
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| author | Richard H. Siderits Jared Fingerman Anup Hazra Cheryl Rimmer Marc Colaco Nagy Mikhail Cristian Ardeleanu Peter M. Mazari |
| author_facet | Richard H. Siderits Jared Fingerman Anup Hazra Cheryl Rimmer Marc Colaco Nagy Mikhail Cristian Ardeleanu Peter M. Mazari |
| author_sort | Richard H. Siderits |
| collection | DOAJ |
| description | Metaplastic changes in the urothelium of the upper urinary tract are relatively infrequent. Metaplasia may present as either squamous or less often glandular differentiation. The process may be associated with chronic inflammation or associated chronic infections. There may be malignant transformation to either squamous cell carcinoma or adenocarcinoma. The demarcation of the metaplastic process in the minor calyces has not been well documented to date. We report the case of a 74-year-old female patient who presented with a history of chronic renal disease and acute pyohydronephrosis. The patient underwent a nephroureterectomy which revealed keratinizing desquamative squamous metaplasia throughout the renal pelvis and upper urinary tract with abrupt termination of metaplasia at the junction of the renal pelvis and the minor calyx (pyramidal zone). Immunohistochemical evaluation documents metaplastic urothelium stained positive for CK5, before converting sharply to simple cuboidal epithelium in the minor calyx (pyramidal zones) which stained positive CK7. At the junction of the metaplastic components and low cuboidal lined minor calyceal surfaces, the underlying stroma showed loss of ureteral muscularis mucosa with transition to renal parenchymal type stroma. We believe that this observation is unique and potentially relevant to the etiology and pathophysiology of pelviceal metaplasia. |
| format | Article |
| id | doaj-art-482cfc3f8658418ea1a88abfa828eaaf |
| institution | Kabale University |
| issn | 2090-696X 2090-6978 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Urology |
| spelling | doaj-art-482cfc3f8658418ea1a88abfa828eaaf2025-08-20T03:36:07ZengWileyCase Reports in Urology2090-696X2090-69782012-01-01201210.1155/2012/242780242780Renal Pelviceal Keratinizing Squamous Metaplasia with Sparing of Pyramidal ZonesRichard H. Siderits0Jared Fingerman1Anup Hazra2Cheryl Rimmer3Marc Colaco4Nagy Mikhail5Cristian Ardeleanu6Peter M. Mazari7Department of Pathology, Robert Wood Johnson University Hospital, Hamilton, NJ 08690-3599, USALawrenceville Urology, Lawrenceville, NJ 08648, USADepartment of Pathology, Robert Wood Johnson University Hospital, Hamilton, NJ 08690-3599, USADepartment of Pathology, Robert Wood Johnson University Hospital, Hamilton, NJ 08690-3599, USARobert Wood Johnson University Medical School, New Brunswick, NJ 08903, USASouthern Ocean County Hospital Pathology, Robert Wood Johnson University Hospital, New Brunswick, NJ 08901, USADepartment of Pathology, Robert Wood Johnson University Hospital, Hamilton, NJ 08690-3599, USARobert Wood Johnson University Medical School, New Brunswick, NJ 08903, USAMetaplastic changes in the urothelium of the upper urinary tract are relatively infrequent. Metaplasia may present as either squamous or less often glandular differentiation. The process may be associated with chronic inflammation or associated chronic infections. There may be malignant transformation to either squamous cell carcinoma or adenocarcinoma. The demarcation of the metaplastic process in the minor calyces has not been well documented to date. We report the case of a 74-year-old female patient who presented with a history of chronic renal disease and acute pyohydronephrosis. The patient underwent a nephroureterectomy which revealed keratinizing desquamative squamous metaplasia throughout the renal pelvis and upper urinary tract with abrupt termination of metaplasia at the junction of the renal pelvis and the minor calyx (pyramidal zone). Immunohistochemical evaluation documents metaplastic urothelium stained positive for CK5, before converting sharply to simple cuboidal epithelium in the minor calyx (pyramidal zones) which stained positive CK7. At the junction of the metaplastic components and low cuboidal lined minor calyceal surfaces, the underlying stroma showed loss of ureteral muscularis mucosa with transition to renal parenchymal type stroma. We believe that this observation is unique and potentially relevant to the etiology and pathophysiology of pelviceal metaplasia.http://dx.doi.org/10.1155/2012/242780 |
| spellingShingle | Richard H. Siderits Jared Fingerman Anup Hazra Cheryl Rimmer Marc Colaco Nagy Mikhail Cristian Ardeleanu Peter M. Mazari Renal Pelviceal Keratinizing Squamous Metaplasia with Sparing of Pyramidal Zones Case Reports in Urology |
| title | Renal Pelviceal Keratinizing Squamous Metaplasia with Sparing of Pyramidal Zones |
| title_full | Renal Pelviceal Keratinizing Squamous Metaplasia with Sparing of Pyramidal Zones |
| title_fullStr | Renal Pelviceal Keratinizing Squamous Metaplasia with Sparing of Pyramidal Zones |
| title_full_unstemmed | Renal Pelviceal Keratinizing Squamous Metaplasia with Sparing of Pyramidal Zones |
| title_short | Renal Pelviceal Keratinizing Squamous Metaplasia with Sparing of Pyramidal Zones |
| title_sort | renal pelviceal keratinizing squamous metaplasia with sparing of pyramidal zones |
| url | http://dx.doi.org/10.1155/2012/242780 |
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