PMC8850297_01
Radiographic and ultrasonography (US) images of the bilateral hydronephrosis in a cat with bilateral ureteral anomalies. (A) It is observed that both kidneys overlap below the second to fourth lumbar vertebrae in the right lateral view. (B) When the length of the second lumbar vertebra was compared with the bilateral height measured by line in ventrodorsal view, the right kidney (5.51 cm) was measured to be 3.3 times the L2 length (1.53 cm), and the left kidney (5.05 cm) was measured to be 3.6 times the L2 length (1.53 cm). (C) A transverse US image shows pyelectasis of the right kidney. The height of the right renal pelvis was measured to be 14.6 mm. (D) A transverse US image shows the pyelectasis of the left kidney. The height of the left renal pelvis was measured to be 4.8 mm. (E) Focal polypoid mural thickening was observed in the middle of the right ureter. Focally thickened ureteral wall can be seen in circumferential form, and the thickness of the ureteral wall was measured to be 2.3 mm for the dorsal part and 2.5 mm for the ventral part. (F) Focal polypoid mural thickening was observed in the middle of the left ureter. Focally thickened ureteral wall can be seen in circumferential form, and the thickness of the ureteral wall was measured to be 1.5 mm for the dorsal part and 1.8 mm for the ventral part.
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F1
The pyelectasis was more severe on the right side, with 14.6 mm on the right and 4.8 mm on the left in the transverse plane (suggested normal range, <=3 mm) (Figures 1C-F).
Post-contrast computed tomography (CT) images of hydronephrosis in a cat with bilateral ureteral anomalies. (A,B) Focal thickening of the right and left ureteral wall was observed on the dorsal plane of CT image in the area indicated by the dotted circle. (C,D) Focal thickening of the right and left ureteral wall was observed on the transverse plane of the CT image in the area indicated by the dotted circle.
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F2
After contrast injection, peripheral rim enhancement (HU: 140-180) was observed on the lesion after intravenous contrast injection (Figure 2).
Anatomy of right kidney and right ureter and histopathology of right ureter stained with hematoxylin and eosin (H&E) staining. (A) The enlarged right kidney and focally thickened ureter (arrow) were observed. (B) The surface of the thickened ureteral wall was irregularly protruded. (C) When the right kidney was dissected, the renal pelvis was severely dilated, and the cortex was yellowish, unlike the normal reddish-brown color. (D) Numerous invaginated folds of uroepithelium are observed at the right ureteral malformation. H&E, x20, Scale bar = 500 mum. (E) Invaginated folds and embedded nests of uroepithelium appear to be entrapped within the smooth muscle layer of the ureter. No epithelial dysplasia is identified. H&E, x 100, Scale bar = 100 mum.
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F3
When the kidney was dissected, the renal pelvis was severely dilated, and it was found that the cortex degenerated to yellowish (Figures 3A,C). When the areas were cut in half, they found that the surfaces of the lumens were irregularly protruded (Figures 3A,B). Microscopic findings from the hematoxylin and eosin (H&E) staining were consistent with bilateral atypical papillary hyperplasia and folding of the transitional epithelium of the ureter (Figures 3D,E).
Postoperative US images of left kidney. (A) Sagittal image. (B) Transverse image. Three days after surgery, the left renal pelvic height was observed to be within 2 mm on US, and a nephrostomy tube was observed normally as two parallel lines in the renal pelvis (white arrow).
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F4
Three days after surgery, the left renal pelvic height was observed to be within 2 mm on US, and a nephrostomy tube was observed normally in the renal pelvis (Figure 4).