26445413 Visualization

A 33 Age - year Age - old Age man Sex presented Clinical_event with left Biological_structure flank Biological_structure dull Detailed_description ache Sign_symptom .
On the abdominal Biological_structure computed Diagnostic_procedure tomography Diagnostic_procedure , a solid Detailed_description renal Biological_structure mass Sign_symptom in the upper Biological_structure portion Biological_structure of Biological_structure the Biological_structure left Biological_structure kidney Biological_structure was identified.
The mass Coreference was measured 2.8 Volume cm Volume   × Volume   2.8 Volume cm Volume   × Volume   2.5 Volume cm Volume in size, was well Detailed_description - defined Detailed_description .
The patient had no other Sign_symptom abnormal Sign_symptom findings Sign_symptom , such as suspected distant Detailed_description metastasis Sign_symptom or lymph Biological_structure node Biological_structure metastasis Sign_symptom .
Radical Detailed_description nephrectomy Therapeutic_procedure was performed on 14/9/2005 Date .
On gross Diagnostic_procedure examination Diagnostic_procedure , the nephrectomy Detailed_description specimen Detailed_description measured 11.5 Volume cm Volume   × Volume   6.5 Volume cm Volume   × Volume   4.5 Volume cm Volume and the tumor Coreference was a solid Detailed_description , grayish Color - brown Color mass Coreference measured 3.5 Volume cm Volume   × Volume   2.5 Volume cm Volume   × Volume   2.2 Volume cm Volume in size.
Histologic Diagnostic_procedure examination Diagnostic_procedure demonstrated trabecular Lab_value and Lab_value ribbonlike Lab_value patterns Lab_value with minimal Lab_value fibrotic Lab_value stroma Lab_value .
The cytoplasm Diagnostic_procedure was granular Lab_value and eosinophilic Lab_value with uniform Lab_value round Lab_value to Lab_value oval Lab_value nuclei Lab_value with finely Lab_value stippled Lab_value chromatin Lab_value and inconspicuous Lab_value nucleoli Lab_value .
Mitoses Diagnostic_procedure were not Lab_value found Lab_value ( 0 Lab_value per Lab_value 10 Lab_value high Lab_value - power Lab_value fields Lab_value ) on H&E Diagnostic_procedure stain Diagnostic_procedure .
The final pathologic Diagnostic_procedure examination Diagnostic_procedure revealed a well Detailed_description - differentiated Detailed_description neuroendocrine Disease_disorder (carcinoid) Disease_disorder tumor Disease_disorder confined to the kidney Biological_structure (Fig.1).
Immunohistochemical Diagnostic_procedure stains Diagnostic_procedure demonstrated labeling Lab_value with chromogranin Diagnostic_procedure , neuron Diagnostic_procedure - specific Diagnostic_procedure enolase Diagnostic_procedure and synaptophysin Diagnostic_procedure (Fig.2), and the proliferation Diagnostic_procedure index Diagnostic_procedure was less Lab_value than Lab_value 2 Lab_value % Lab_value as measured by immunohistochemistry Diagnostic_procedure for Diagnostic_procedure Ki-67.
Further radiation Therapeutic_procedure and chemotherapy Medication were not received.
Nine Date years Date after Date radical nephrectomy, computed Diagnostic_procedure tomography Diagnostic_procedure of the abdomen Biological_structure demonstrated a 2 Area cm Area   × Area   1.8 Area cm Area cyst Detailed_description mass Sign_symptom in the right Biological_structure liver Biological_structure and multiple Detailed_description high Sign_symptom density Sign_symptom shadow Sign_symptom in gallbladder Biological_structure .
No enlarged Sign_symptom lymph Biological_structure nodes Biological_structure were found in the abdominal Biological_structure cavity Biological_structure .
Cholecystectomy Therapeutic_procedure and extirpation Therapeutic_procedure for hepatic Disease_disorder cyst Disease_disorder were performed by laparoscopy Therapeutic_procedure surgery Therapeutic_procedure .
Histologic Diagnostic_procedure examination Diagnostic_procedure demonstrated trabecular Lab_value and Lab_value glandlike Lab_value growth Lab_value (Fig.3), moderate Lab_value and Lab_value uniform Lab_value nuclei Lab_value and mitoses Diagnostic_procedure weren't Lab_value found Lab_value ( 0 Lab_value per Lab_value 10 Lab_value high Lab_value - power Lab_value fields Lab_value ).
Advanced Detailed_description immunohistochemistry Diagnostic_procedure revealed that the lesion Coreference was positive Lab_value for synaptophysin Diagnostic_procedure (Fig.4) and CD56, but negative Lab_value for chromogranin Diagnostic_procedure and neuron Diagnostic_procedure - specific Diagnostic_procedure enolase Diagnostic_procedure .
These features are supported in a neuroendocrine Disease_disorder tumor Disease_disorder .
Due to the similar pathologic characteristics between the primary renal carcinoid tumor and liver tumor.
The final pathology report indicated a carcinoid Disease_disorder tumor Disease_disorder of the left Biological_structure kidney Biological_structure with liver Biological_structure metastasis Sign_symptom .