PMC9851858_01
A. Contrast-enhanced CT showing findings consistent with a left renal abscess, hydronephrosis, and ipsilateral staghorn calculus. B. Product of simple left nephrectomy with loss of normal renal architecture, dilation of the pyelocaliceal system, and presence of exophytic lesions with papillary appearance in the renal pelvis (white arrow) that macroscopically extend close to the ureteral surgical border (black arrow).
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It revealed a left renal abscess, hydronephrosis, and a staghorn calculus, for which percutaneous drainage was placed (Fig. 1A). Gross examination revealed a terminal kidney, a staghorn calculus occupying the renal pelvis, purulent fluid, and multiple exophytic lesions with a papillary appearance, which extended close to the ureteral surgical border (Fig. 1 B).
A. Villoglandular fronds lined by pseudostratified columnar epithelium (H&E, x10). B. Foci of intestinal metaplasia present in the urothelium of the renal pelvis and ureteral surgical border (H&E, x10). C. Microscopic focus of intestinal-type adenocarcinoma with infiltration of the lamina propria (H&E, x10).
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Another finding was of intestinal-type adenocarcinoma with microinvasion to the lamina propria (Fig. 2).
Immunohistochemistry (IHC). A. Nuclear positivity for CDX2. B. Cytoplasmic positivity for CK20. C. Nuclear positivity for SATB2.
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Immunohistochemistry (IHC) stains were performed for CK20, CDX2, and SATB2, all of which were positive and corroborated the intestinal differentiation of the tumor (Fig. 3).