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Incidence of benign results after laparoscopic radical nephroureterectomy.

Hong S, Kwon T, You D, Jeong IG, Hong B, Hong JH, Ahn H, Kim CS - JSLS (2014 Oct-Dec)

Bottom Line: The preoperative features of these patients were investigated, including imaging findings, urine cytologic results, and ureteroscopic findings.In 2 patients, stones were detected (stone with atypical papillary urothelial hyperplasia and polypoid ureteritis with ureter stone, respectively) after laparoscopic RNU.The description of these false-positive cases will help improve the preoperative counseling of these patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Dankook University College of Medicine, Cheonan, Korea.

ABSTRACT

Background and objectives: Studies of patients with benign pathologic lesions who underwent laparoscopic radical nephroureterectomy (RNU) with preoperative suspicion of upper urinary tract urothelial carcinoma are lacking. The aim of this retrospective cross-sectional study was to evaluate the incidence of benign pathologic lesions on laparoscopic RNU for upper urinary tract tumors that are presumed to be urothelial carcinoma. The clinicopathologic characteristics of these lesions were also determined.

Methods: Between January 2004 and December 2010, 244 patients underwent laparoscopic RNU for possible upper urinary tract urothelial carcinoma at our institute. Seven (2.9%) had benign lesions at the final pathologic examination. The preoperative features of these patients were investigated, including imaging findings, urine cytologic results, and ureteroscopic findings.

Results: The 7 patients comprised 5 men and 2 women. The lesions were located in the ureter in 5 patients and in the renal pelvis in 2. All patients underwent preoperative voided urine cytology and cystoscopy. Two patients underwent preoperative ureteroscopy. In 1 patient, definite pathologic lesions were not identified in the surgical specimen. Urinary tract tuberculosis was diagnosed in 1 patient, inflammatory pseudotumor in 2, and fibroepithelial polyps in 1. In 2 patients, stones were detected (stone with atypical papillary urothelial hyperplasia and polypoid ureteritis with ureter stone, respectively) after laparoscopic RNU.

Conclusion: Benign pathologic lesions were detected in 7 patients (2.9%) who had undergone laparoscopic RNU for upper urinary tract tumors that were presumed to be urothelial carcinoma. The description of these false-positive cases will help improve the preoperative counseling of these patients.

No MeSH data available.


Related in: MedlinePlus

A benign lesion caused by mucosal and submucosal hemorrhage with transmural congestion in a 52-year-old woman with right flank pain. A delay pelvis image scan shows an enhancing soft tissue lesion in the right distal ureter (left, circle) causing hydroureteronephrosis of the right kidney and resulting in decreased perfusion of the right renal parenchyma (right).
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Figure 1: A benign lesion caused by mucosal and submucosal hemorrhage with transmural congestion in a 52-year-old woman with right flank pain. A delay pelvis image scan shows an enhancing soft tissue lesion in the right distal ureter (left, circle) causing hydroureteronephrosis of the right kidney and resulting in decreased perfusion of the right renal parenchyma (right).

Mentions: Interestingly, the specimen removed from patient 6, a 52-year-old woman, showed no definite abnormal findings. This patient had visited our outpatient clinic complaining of pain in the right flank. On CT urography, an enhancing lesion that was causing hydroureteronephrosis was detected in the right distal ureter. There was also a moderate decrease in enhancement in the renal parenchyma (Figure 1). Her cystoscopic findings were normal, and voided urine cytology also provided no evidence of malignancy. During RGP, a 5-Fr open-ended ureteral catheter could not be advanced because of the near-complete obstruction of the right distal ureter. When endoscopic biopsy specimens around the obstructive lesion were obtained randomly, they were subsequently determined to mainly constitute a few atypical cells and fibrous tissue. The final pathology of the removed ureter, after the patient underwent laparoscopic RNU, reported a benign lesion that was caused by mucosal and submucosal hemorrhage with transmural congestion.


Incidence of benign results after laparoscopic radical nephroureterectomy.

Hong S, Kwon T, You D, Jeong IG, Hong B, Hong JH, Ahn H, Kim CS - JSLS (2014 Oct-Dec)

A benign lesion caused by mucosal and submucosal hemorrhage with transmural congestion in a 52-year-old woman with right flank pain. A delay pelvis image scan shows an enhancing soft tissue lesion in the right distal ureter (left, circle) causing hydroureteronephrosis of the right kidney and resulting in decreased perfusion of the right renal parenchyma (right).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4232409&req=5

Figure 1: A benign lesion caused by mucosal and submucosal hemorrhage with transmural congestion in a 52-year-old woman with right flank pain. A delay pelvis image scan shows an enhancing soft tissue lesion in the right distal ureter (left, circle) causing hydroureteronephrosis of the right kidney and resulting in decreased perfusion of the right renal parenchyma (right).
Mentions: Interestingly, the specimen removed from patient 6, a 52-year-old woman, showed no definite abnormal findings. This patient had visited our outpatient clinic complaining of pain in the right flank. On CT urography, an enhancing lesion that was causing hydroureteronephrosis was detected in the right distal ureter. There was also a moderate decrease in enhancement in the renal parenchyma (Figure 1). Her cystoscopic findings were normal, and voided urine cytology also provided no evidence of malignancy. During RGP, a 5-Fr open-ended ureteral catheter could not be advanced because of the near-complete obstruction of the right distal ureter. When endoscopic biopsy specimens around the obstructive lesion were obtained randomly, they were subsequently determined to mainly constitute a few atypical cells and fibrous tissue. The final pathology of the removed ureter, after the patient underwent laparoscopic RNU, reported a benign lesion that was caused by mucosal and submucosal hemorrhage with transmural congestion.

Bottom Line: The preoperative features of these patients were investigated, including imaging findings, urine cytologic results, and ureteroscopic findings.In 2 patients, stones were detected (stone with atypical papillary urothelial hyperplasia and polypoid ureteritis with ureter stone, respectively) after laparoscopic RNU.The description of these false-positive cases will help improve the preoperative counseling of these patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Dankook University College of Medicine, Cheonan, Korea.

ABSTRACT

Background and objectives: Studies of patients with benign pathologic lesions who underwent laparoscopic radical nephroureterectomy (RNU) with preoperative suspicion of upper urinary tract urothelial carcinoma are lacking. The aim of this retrospective cross-sectional study was to evaluate the incidence of benign pathologic lesions on laparoscopic RNU for upper urinary tract tumors that are presumed to be urothelial carcinoma. The clinicopathologic characteristics of these lesions were also determined.

Methods: Between January 2004 and December 2010, 244 patients underwent laparoscopic RNU for possible upper urinary tract urothelial carcinoma at our institute. Seven (2.9%) had benign lesions at the final pathologic examination. The preoperative features of these patients were investigated, including imaging findings, urine cytologic results, and ureteroscopic findings.

Results: The 7 patients comprised 5 men and 2 women. The lesions were located in the ureter in 5 patients and in the renal pelvis in 2. All patients underwent preoperative voided urine cytology and cystoscopy. Two patients underwent preoperative ureteroscopy. In 1 patient, definite pathologic lesions were not identified in the surgical specimen. Urinary tract tuberculosis was diagnosed in 1 patient, inflammatory pseudotumor in 2, and fibroepithelial polyps in 1. In 2 patients, stones were detected (stone with atypical papillary urothelial hyperplasia and polypoid ureteritis with ureter stone, respectively) after laparoscopic RNU.

Conclusion: Benign pathologic lesions were detected in 7 patients (2.9%) who had undergone laparoscopic RNU for upper urinary tract tumors that were presumed to be urothelial carcinoma. The description of these false-positive cases will help improve the preoperative counseling of these patients.

No MeSH data available.


Related in: MedlinePlus