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Mucinous adenocarcinoma of the kidney is rarely reported in the literature. We present a previously unreported mucinous adenocarcinoma arising from the renal parenchyma. A 55-year-old male patient with no complaints showed a large cystic hypodense lesion in the upper left kidney on contrast-enhanced computed tomography (CT) scan. A left renal cyst was initially considered, and a partial nephrectomy (PN) was performed. During the operation, a large amount of jelly-like mucus and bean-curd-like necrotic tissue was found in the focus. The pathological diagnosis was mucinous adenocarcinoma, and further systemic examination revealed no clinical evidence of primary disease elsewhere. Then the patient underwent left radical nephrectomy (RN), and the cystic lesion was found in the renal parenchyma, while neither the collecting system nor the ureters were involved. Postoperative sequential chemotherapy and radiotherapy were administered, and no signs of disease recurrence were observed over 30 months of follow-up. Based on a literature review, we summarize the lesion with rarity and the associated dilemma in preoperative diagnosis and treatment. Given the high degree of malignancy, a careful history analysis accompanied by dynamic observation of imaging and tumor markers is recommended for the diagnosis of the disease. Comprehensive treatment based on surgery may improve its clinical outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate quantitative parameters derived from intravoxel incoherent motion diffusion-weighted MRI (IVIM) of renal parenchyma in patients with untreated acute leukemia (AL) and analyze its prognostic significance and probable pathological mechanism. Methods: From March 2019 to November 2021, 67 newly diagnosed AL patients and 67 healthy controls matched in age and sex were recruited. All participants underwent IVIM in the kidneys, and D, D*, f, standard ADC values were measured. The differences of all parameters between AL and controls were analyzed. The relationship between imaging parameters and estimated glomerular filtration rate (eGFR) was studied. Univariable and multivariable analyses were performed to investigate prognostic significance of possible indicators. Results: The f and D value of renal medulla and D value of renal cortex in AL patients were lower than those in the healthy control group (t = − 2.173, t = − 3.463, t = − 2.030, respectively, all P < 0.05). The cortical f, cortical standard ADC, medullary f, and medullary standard ADC were correlated with the eGFR (r = 0.524, r = 0.401, r = 0.415, r = 0.325, respectively, all P < 0.05) in patients with AL. A medullary f value ≤ 9.51% (hazard ratio: 0.282; 95% confidence interval: 0.110, 0.719; P = 0.008) was associated with overall survival in a multivariable analysis. Conclusion: The f and standard ADC values in renal parenchyma were the probable imaging markers of renal function in patients with newly diagnosed de novo AL. Lower renal medullary f value was a potential independent predictor for overall survival. [ABSTRACT FROM AUTHOR]

Rationale: Primary renal parenchymal squamous cell carcinoma (SCC) is an extremely rare tumor that is difficult to diagnose by hematology and imaging studies and is often diagnosed later than other primary renal cancers. Diagnosis: A 52-year-old male patient was found to have cysts in both kidneys for 1 week. No urgency and frequency of urination, no dysuria, no gross hematuria, and no significant changes in recent body weight were reported. Interventions: The upper pole of the right kidney is a cystic and solid mass (8.3 cm * 8.2 cm * 8.1 cm), the cystic part has long T1 and long T2 signals, the solid part has mixed signals, and some parts have limited diffusion. There were nodular long T1 and short T2 calcification signals. An enhanced scan of the solid part showed uneven enhancement and continuous enhancement of the mass capsule. Cystic renal cancer was considered because of the multiple cysts in both kidneys. Surgical treatment was performed. Postoperative pathology revealed well-differentiated squamous cell carcinoma of the right kidney with cystic degeneration, 8.5 cm * 6 cm in size, infiltrating the renal parenchyma, and the cutting edge was negative. The pathological stage was pT2bN0M0. Outcome: At the follow-up 5 months after the operation, no metastasis was found. Conclusion: Renal SCC is rare and easily misdiagnosed and missed. Pathological diagnosis is still the gold standard for its diagnosis. However, with active surgical treatment, the short-term prognosis of the patient is good. [ABSTRACT FROM AUTHOR]

Infectious bronchitis (IB) is an economically important disease with worldwide distribution. Information is available about the presence of infectious bronchitis virus in commercial poultry in different geographical regions of Pakistan, however no comprehensive information is available about status of infectious bronchitis in commercial poultry. For this purpose, current study was designed for the seroprevalence of Infectious Bronchitis Virus (IBV) from different commercial poultry farms in Faisalabad division and its adjoining areas. Samples were collected at different age groups and different breeds. Serological detection was carried out by two different means Hemagglutination Inhibition (HI) and Enzyme Linked Immunosorbent Assay (ELISA). In HI, 346 samples from 56 broilers farms were tested for IB and from these 58 (16.8%) samples were positive for IBV tested against 4/91 antigen and 133 (38.4%) samples were positive tested against M-41 antigen. Total of 388 layers samples from 61 layer farms were tested for IB and from these 68 (17.5%) samples were found positive for IBV tested against 4/91 antigen and 184 (47.42%) samples were positive tested against M-41 antigen. In case of ELISA, 1843 samples of layer were processed and 98.48% were found positive, while in case of broilers, from 346 samples, 148 (42.80%) samples were found positive. Grossly hemorrhagic trachea and swollen kidneys were consistent gross findings in all the seropositive birds. Histopathology results showed that there was sloughing of tracheal epithelium and loss of cilia. Renal parenchyma was showing moderate to severe congestion and moderate degree of acute tubular necrosis. The results concluded that there is strong presence and low protection of IB in broiler birds and due to this there is continuous emergence and rise in the disease outbreaks in spite of vaccination. Therefore, proper vaccination schedule with specific vaccinal strains should be followed in broilers and layers to control infectious bronchitis in commercial poultry. [ABSTRACT FROM AUTHOR]

Fat‐poor leiomyomatous angiomyolipoma, which is similar to smooth muscle tumors, is positive for smooth muscle markers and melanocytic marker human melanin black 45 (HMB‐45). We report a case of fat‐poor leiomyomatous angiomyolipoma arising from renal parenchyma negative for HMB‐45 diagnosed by combined staining with melanocytic markers HMB‐45 and Melan‐A. [ABSTRACT FROM AUTHOR]

Abstract Fat‐poor leiomyomatous angiomyolipoma, which is similar to smooth muscle tumors, is positive for smooth muscle markers and melanocytic marker human melanin black 45 (HMB‐45). We report a case of fat‐poor leiomyomatous angiomyolipoma arising from renal parenchyma negative for HMB‐45 diagnosed by combined staining with melanocytic markers HMB‐45 and Melan‐A.

The purpose of the work is a comparative assessment of the effect of boron hydrocarbonate sodium mineral waters with a varying quantitative and qualitative composition of macroelements and with different amounts of a bioactive element on the state of the urinary system of rats. Materials and methods. The work was performed on 81 white rats of the Wistar line of auto bred breeding, weighing 180-200 g. The rats were divided into four groups: group 1 - 21 intact rats served as controls; group 2 - 20 rats treated intragastrically with a soft probe MW "Polyana Ploskivskaya" at a dose of 1% of body weight daily, a course of 7 days; group 3 - 20 rats treated with MW "Polyana Kupel" according to the above method; group 4 - 20 rats treated with MW "Svalyava" according to the above process. Before removing the animals from the experiment, daily urine was collected from them; blood was also taken from the tail vein for biochemical studies. At autopsy, pieces of kidneys were taken for histological and histoenzymological studies (the activity of succinate dehydrogenase and lactate dehydrogenase was determined). Results. The histological studies showed no pathological changes in the kidneys were observed with the use of the studied boron MW. Still, there were structural changes, as well as an increase in the activity of redox enzymes. Changes in kidney function were unidirectional with using any of the investigated MW. Still, they had quantitative differences, which are less related to the amount of boron (in the form of orthoboric acid) in 1 liter of MW and more dependent on the osmolarity of the MW, the qualitative composition of macronutrients, and their ratio. Conclusion. We believe that osmolarity, as an integrated indicator of the state of the macronutrient component of MW, can be used to assess its effect on the structural and functional characteristics of the kidneys.

Background: During ureteroscopy, severe ureter straightness or contortion may occur before the stone is passed. Purpose: To identify clinical factors associated with distal ureteral status below the ureteral calculi in patients before surgery. Material and Methods: From October 2016 to March 2017, 101 patients with ureteral calculi who underwent ureteroscopic lithotripsy were reviewed. Patients who lacked clinical data and underwent preoperative indwelling ureteral stent placement were excluded. Univariate and multivariate analyses were performed to determine the clinical factors associated with intraoperative findings. Results: A total of 101 patients were enrolled in the study (mean age = 54 years; mean stone size = 7.9 ± 4.5 mm). Overall, 25 of the 101 patients (24.7%) were diagnosed with poor distal ureteral status defined as intraoperative ureterostenosis or contortion resulting in a ureteroscope being unable to pass during the initial attempt. Univariate analysis showed significant differences in renal parenchyma thickness, ureteral wall thickening on imaging, and stone location (all, P < 0.05) with and without poor distal ureteral status. On multivariable analysis, renal parenchyma thickness (adjusted odds ratio [aOR] 0.288; 95% confidence interval [CI] 0.099–0.838; P = 0.022) and ureteral wall thickening on imaging (aOR 6.114; 95% CI 2.015–18.548; P = 0.001) independently predicted poor distal ureteral status. However, only renal parenchyma thickness was associated with severe ureter straightness or tortuosity that resulted in conversion. Conclusion: In conclusion, renal parenchyma thickness and ureteral wall thickening on imaging were associated with poor distal ureteral status. Therefore, patients with these predictive factors should undergo more intensive preparation before surgery. [ABSTRACT FROM AUTHOR]

Abstract Background Primary squamous cell carcinoma of the renal parenchyma is extremely rare, only 5 cases were reported. Case presentation We probably report the fifth case of primary Squamous cell carcinoma (SCC) of the renal parenchyma in a 61-year-old female presenting with intermittent distending pain for 2 months. Contrast-enhanced computed tomography (CECT) revealed hydronephrosis of the right kidney, but a tumor cannot be excluded completely. Finally, nephrectomy was performed, and histological analysis determined that the diagnosis was kidney parenchyma squamous cell carcinoma involving perinephric adipose tissue. Conclusions The present case emphasizes that it is difficult to make an accurate preoperative diagnosis with the presentation of hidden malignancy, such as hydronephrosis.

There are unexplained geographical variations in the incidence of kidney cancer with the high rates reported in Baltic countries, as well as eastern and central Europe. Having access to a large and well-annotated collection of "tumor/non-tumor" pairs of kidney cancer patients from the Czech Republic, Romania, Serbia, UK, and Russia, we aimed to analyze the morphology of non-neoplastic renal tissue in nephrectomy specimens. By applying digital pathology, we performed a microscopic examination of 1012 frozen non-neoplastic kidney tissues from patients with renal cell carcinoma. Four components of renal parenchyma were evaluated and scored for the intensity of interstitial inflammation and fibrosis, tubular atrophy, glomerulosclerosis, and arterial wall thickening, globally called chronic renal parenchymal changes. Moderate or severe changes were observed in 54 (5.3%) of patients with predominance of occurrence in Romania (OR = 2.67, CI 1.07–6.67) and Serbia (OR = 4.37, CI 1.20–15.96) in reference to those from Russia. Further adjustment for comorbidities, tumor characteristics, and stage did not change risk estimates. In multinomial regression model, relative probability of non-glomerular changes was 5.22 times higher for Romania and Serbia compared to Russia. Our findings show that the frequency of chronic renal parenchymal changes, with the predominance of chronic interstitial nephritis pattern, in kidney cancer patients varies by country, significantly more frequent in countries located in central and southeastern Europe where the incidence of kidney cancer has been reported to be moderate to high. The observed association between these pathological features and living in certain geographic areas requires a larger population-based study to confirm this association on a large scale. [ABSTRACT FROM AUTHOR]

Chronic kidney disease continues to be under recognised and is associated with a significant global health burden and costs. An adverse intrauterine environment may result in a depleted nephron number and an increased risk of chronic kidney disease. Antenatal ultrasound was used to measure the foetal renal parenchymal thickness (RPT), as a novel method to estimate nephron number. Foetal renal artery blood flow was also assessed. This prospective, longitudinal study evaluated the foetal kidneys of 102 appropriately grown and 30 foetal growth-restricted foetuses between 20 and 37 weeks gestational age (GA) to provide vital knowledge on the influences foetal growth restriction has on the developing kidneys. The foetal RPT and renal artery blood flow were measured at least every 4 weeks using ultrasound. The RPT was found to be significantly thinner in growth-restricted foetuses compared to appropriately grown foetuses [likelihood ratio (LR) = 21.06, P ≤ 0.0001] and the difference increases with GA. In foetuses with the same head circumference, a growth-restricted foetus was more likely to have a thinner parenchyma than an appropriately grown foetus (LR = 8.9, P = 0.0028), supporting the principle that growth-restricted foetuses preferentially shunt blood towards the brain. No significant difference was seen in the renal arteries between appropriately grown and growth-restricted foetuses. Measurement of the RPT appears to be a more sensitive measure than current methods. It has the potential to identify infants with a possible reduced nephron endowment allowing for monitoring and interventions to be focused on individuals at a higher risk of developing future hypertension and chronic kidney disease. [ABSTRACT FROM AUTHOR]

Emphysematous pyelonephritis (EPN) represents a severe and acute infection localized in the renal parenchyma and surrounding perirenal area, typically observed in individuals with predisposing factors such as urinary tract obstruction, diabetes mellitus, or compromised immune function. Here, we present a unique case involving a 23-year-old female patient presenting to the emergency department with complaints of discomfort localized to the right side of her abdomen. Despite the absence of diabetes mellitus, the patient was diagnosed with EPN based on clinical presentation and imaging findings. Prompt and effective management was initiated under the care of the urology department, highlighting the importance of early recognition and intervention in mitigating the potential complications associated with this severe infectious process., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Khaladkar et al.)

Purpose: To delineate the expansion of the renal parenchyma using volumetric CT imaging before and after the laparoscopic cyst decortication procedure and to determine the possible associations between parenchymal expansion and laboratory parameters and cyst volume.Materials and Methods: Thirty-five patients that underwent laparoscopic cyst decortication were included in this prospective study. Abdominal contrast-enhanced CT was performed in all patients in the preoperative and postoperative period. Semi-automatic volume quantification was undertaken offline, and renal parenchymal volumes before and after cyst decortication, as well as serum creatinine and estimated glomerular filtration rate (eGFR) were compared.Results: The changes in serum creatinine and eGFR in the postoperative period were non-significant. The mean postoperative renal parenchymal volumes were higher compared to the preoperative measurements for both observations (P = .014 and .034 for the first and second measurements, respectively). There was no correlation between the volumetric change and the cyst volume (r = -0.18, P = .560).Conclusion: In patients undergoing laparoscopic cyst decortication, post-operative parenchymal expansion can be detected using volumetric CT imaging to confirm the immediate benefits of the procedure. [ABSTRACT FROM AUTHOR]

Background: Primary squamous cell carcinoma of the renal parenchyma is extremely rare, only 5 cases were reported.Case Presentation: We probably report the fifth case of primary Squamous cell carcinoma (SCC) of the renal parenchyma in a 61-year-old female presenting with intermittent distending pain for 2 months. Contrast-enhanced computed tomography (CECT) revealed hydronephrosis of the right kidney, but a tumor cannot be excluded completely. Finally, nephrectomy was performed, and histological analysis determined that the diagnosis was kidney parenchyma squamous cell carcinoma involving perinephric adipose tissue.Conclusions: The present case emphasizes that it is difficult to make an accurate preoperative diagnosis with the presentation of hidden malignancy, such as hydronephrosis. [ABSTRACT FROM AUTHOR]

The buckthorn "Rhamnus alaternus" is a plant used in traditional medicine especially in the treatment of certain diseases such as diabetes, cardiovascular disease and dyslipidemia. The aim of our study was to analysed and evaluate the effects of buckthorn on nephroangiosclerosis Wistar rats. Thirty male Wistar rats, adult weighing between 120g and 250g were distributed as follows: Five control animals received a standard laboratory diet, thirty four experimental rats received the standard laboratory diet supplemented with palm oil and 4% of NaCl (High Sold Fat Diet). After six month of this diet the HSFD group was subdivided into rats treated for 45 days with aqueous extract of buckthorn or animals HSFD only. Plasma metabolites and endothelin-1 concentration were measured by standard methods, section of kidney were stained by Heindenhain-azan and periodic acid shiff. The examination of renal parenchyma of HSFD rats showed a prominent structural changes such as, obstruction of vascular lumen, ischemia of the glomerular and tubulo-interstitial fibrosis the biochemical and hormonal parameters were significantly improved in the HSFD rats treated with decoction of buckthorn. Moreover, the morphogical changes of the renal parenchyma were attenuated in rats HSFD decoction. The buckthorn attenuates renal parenchymal lesions by aggregating at different levels of rats maintained on HSFD. [ABSTRACT FROM AUTHOR]

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Objectives: We propose a calculus-based formula to calculate contact surface area (CSA). We examined the correlation of CSA and renal volume loss and the predictability for renal function after partial nephrectomy (PN). Materials and methods: We conducted a retrospective study in patients who underwent PN between January 2012 and December 2014. Based on abdominopelvic computed tomography and magnetic resonance imaging, we calculated the CSA with the formula: 2 × π × r × d; where r = radius and d = depth, while resected and ischemic volume (RAIV) was determined by the equation [2w2 + 3w(r + d) + 6rd] × w × π⁄3, where w = width of parenchymal ischemia and resection, r = radius, and d = depth. We evaluated the correlation between CSA, RAIV, and perioperative parameters. We compared the ability of CSA and RAIV to predict the reduction in renal function. Results: There were 35, 26, and 45 patients receiving open, laparoscopic, or robot-assisted PN, respectively. The mean ± standard deviation CSA was 30.7 ± 26.1 cm2, and the mean ± standard deviation RAIV was 19.1 ± 14.4 cm3. In Spearman correlation analysis, we found that CSA and RAIV were highly correlated (coefficient: 0.99, p 10% change in estimated glomerular filtration rate (area under the curve: 0.86 vs. 0.87). There was no significant difference in area under the curve between CSA and RAIV. The area difference in PCE10 was 0.002 (p = 0.51). Conclusion: CSA and RAIV were correlated with several perioperative outcomes and affected PRF. The ability to predict PRF between CSA and RAIV was nearly identical. CSA was simpler to use, and may possess less interobserver variability in comparison with RAIV. Therefore, we believe that CSA can represent renal parenchymal loss.

The article describes the results of observation of the patient with stenosis of the main artery of the transplanted kidney before and after balloon dilation of stenosis. The kidney was studied by Ultrasound, Doppler and Share Wave Elastography (SWE). There is a significant difference between the stiffness of the renal parenchyma, depending on the condition of blood flow. Recovery perfusion parenchyma leads to increased stiffness by 52% of the initial value.

Objective: To evaluate the change in the operated parenchymal volume during robot‐assisted partial nephrectomy limited to the enucleation technique, and to analyze the predictors of decrease in operated parenchymal volume, including the tumor contact surface area. Methods: The study included 135 patients who underwent robot‐assisted partial nephrectomy for T1 renal tumors using the enucleation technique. Measurements of the parenchymal volume, tumor volume and contact surface area were obtained in the venous phase on enhanced computed tomography. All measurements, including volumetric and renal function analysis, were carried out <2 months before and 6 months after surgery. Results: The mean age of included participants was 56 years, and the mean tumor size was 33 mm. The mean tumor volume was 26 cc, and the mean contact surface area was 22 cm2. In the complete cohort, the mean preoperative and postoperative normal parenchymal volumes of the operated kidney were 158 and 141 cc, respectively. The mean change in parenchymal volume of the operated kidney was −10%. In contrast, the mean change in global estimated glomerular filtration was just −4.0%. Univariate analysis showed that the RENAL nephrometry score, contact surface area, tumor volume and warm ischemia time were associated with the change in the operated kidney parenchymal volume. However, in the multivariate analysis, a large contact surface area was the only independent predictor of decreased operated parenchymal volume <10 cm3. Conclusion: Contact surface area is a strong predictor of the decrease in the parenchymal volume in the operated kidney during robot‐assisted partial nephrectomy carried out using the enucleation technique for T1 renal tumors. [ABSTRACT FROM AUTHOR]