PMC3963356_01
Radiological investigations of the left renal unit. (a) An intravenous pyelogram showing no excretion from the left kidney. (b) A diuretic renogram showing no excretion of the left kidney. (c) A retrograde ureterogram showing filling defect of the left ureter at the pelvic brim. (d) A repeat diuretic renogram, 2 weeks after ureteric stent insertion, showing no improvement of excretion of the left kidney
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F1
An intravenous urography showed no excretion from the left kidney [Figure 1a]. A diuretic renogram using 99mTc-MAG3 showed poor excretion of the left kidney [Figure 1b]. A retrograde study was carried out which revealed a short narrow segment in the ureter at the junction of the lumbar and pelvic ureter [Figure 1c]. A repeat renal scan with the JJ stent indwelling for 16 days, failed to show any improvement in renal function or excretion [Figure 1d].
Microscopic examination of the ureter at the level of endometriosis involvement. (a) Hematoxylin and Eosin staining showing endometriosis of the ureter underlying normal epithelium (arrow head). Endometrial stroma (thin arrows) and glands (thick arrow) are seen amidst ureteric musculosa (asterisk, x50). (b) Ureteric musculosa (x200). (c) Ureteric epithelium (x200). (d) Hematoxylin and Eosin staining showing endometrial glands (thick arrow) and stroma (thin arrow, x200). (e) Immunohistochemical staining for estrogen receptor positive in the endometrial glands (arrow, x200). (f) Immunohistochemical staining for CD10 positive in the endometrial stroma (arrow, x200)
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F2
Microscopic examination of the ureteric nodule revealed benign endometrial gland and stroma underlining the normal urothelium [Figure 2a-d]. The endometrial glands were positive for Estrogen receptor [Figure 2e] while the endometrial stroma was positive for CD10 [Figure 2f].