Ar, epithelioid, palisading, spindle, storiform, and anaplastic) are blended together [1]. A > 자유게시판

Ar, epithelioid, palisading, spindle, storiform, and anaplastic) are blended together [1]. A CCSK in a 9-year-old male is described with an atypical pathological status, including gross necrosis and calcification. Case presentation A 9-year-old boy complained of abdominal bloating. Blood parameters, including neuron specific enolase, alpha fetoprotein, and beta human chorionic gonadotropin, were in the normal ranges, and his urinary vanillylmandelic acid and homovanillic acid were not elevated. Unenhanced abdominal computed tomography (CT) revealed a tumor with calcification in the left kidney, with infiltration of the renal sinus and 15 cm wide (Fig. 1a). Contrast-enhanced CT revealed a heterogeneously enhancing mass completely enclosed by the* Correspondence: syuya@dokkyomed.ac.jp 1 Department of Pediatrics, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, Tochigi 321-0293, Japan Full list of author information is available at the end of the articlerenal capsule (Fig. 1b). No metastasis was detected in the lungs, liver, or bone by analysis of CT, magnetic resonance imaging and 99mTc scintigraphy. After complete surgical resection, the tumor showed heterogeneous pathological tissues divided by septa and included necrotic tissue (Fig. 2). Calcification was found around the necrotic tissue, but no macroscopic osteoplasty was observed. Pathological analysis suggested a monomorphic malignant neoplasm composed of plump or spindleshaped cells with elongated, vesicular nuclei or small nuclei and variable amounts of clear cytoplasm (Fig. 3). These results prompted a diagnosis of stage 2 clear cell sarcoma of the kidney (CCSK). The 20 CCSK cells analyzed with fluorescence in situ hybridization (FISH) had an abnormal karyotype, 46,XY,der(3)(3pter 3q23::7?::3?::7p13 7pter)der(7)(X ?::7p11.2 7q22::3?::Xq13 Xqter)der(X)del(X)(p11.2 p22.1)t(X;7)(q11;?) (Fig. 4). This abnormal chromosome has not been reported previously in CCSK. Chemotherapy was administered according to the Japanese Wilms Tumor Study (JWiTS)-2 Regimen I, including vincristine, doxorubicin, and cyclophosphamide. The patient has remained in complete remission for 3 years.Discussion In terms of its pathological features, CCSK is most commonly described as a tan-grey, soft, and mucoid mass on cut section [1, 2]. Cystic foci are nearly universal and?2015 Kato et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License Nelfinavir (Mesylate) (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/16989806 credited. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Kato et al. Diagnostic Pathology (2015) 10:Page 2 ofFig. 1 Computed tomography (CT) findings. a Uncontrasted CT shows a tumor with calcification in the left kidney. b Contrast-enhanced CT shows heterogeneous enhancement and completely enclosed by the renal capsuleoccasionally constitute the dominant feature, prompting radiological and gross pathological diagnoses of multilocular renal cyst [1, 2]. The microscopic appearance of these lesions also mimics cystic nephroma. Within these typically large and relatively homogeneous tumors, discrete foci of necrosis and hemorrhage are common on microscopic analysis [1, 2]. On the contrary, the tumor in our patient appeared as a.