PMC6380136_01
(a) Coronal view of contrast enhanced computerized tomography (CECT) scan of a kidney, ureter, and bladder region showing decreased enhancement of the left kidney with moderate hydroureteronephrosis secondary to mid-ureteric stricture at S3 vertebral level (white hollow arrow). (b) Coronal view of delayed phase of CECT of KUB region showing delayed excretion of contrast from the left kidney with hydroureteronephrosis and stricture at left mid-ureter level (solid white arrow)
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F1
Contrast enhanced computerized tomography (CECT) imaging of the abdomen and pelvis [Figure 1(a)] and isotope renogram revealed poorly functioning left kidney (split renal function 21%) with hydroureteronephrosis due to left mid-ureteric stricture at S3 vertebra level [Figure 1(b)].
(a) Left retrograde pyelography showing mid-ureteric stricture of approximately 1.5 cm (solid white arrow). (b) Fluoroscopic image showing balloon dilation of the stricture segment (solid white arrow). (c) Ureteroscopic view of intraluminal ureteric polyp at the level of stricture (hollow black arrow)
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F2
Left retrograde pyelography (RGP) revealed a passable 1.5 cm stricture in mid-ureter [Figure 2(a)]. Cook  ureteroscopic balloon dilator [Figure 2(b)] followed by ureteroscopy which showed a polypoidal mass of 7 mm in the area of stricture [Figure 2(c)]. Cold cup biopsy of the lesion was done and a 6 Fr 26 cm silicone DJ stent was placed.
(a) Ureteral epithelium (solid black arrow) and endometrial glands (hollow black arrow) are intermixed (H and E, x10). (b) Estrogen receptor positivity shown in the endometrial glands (hollow black arrow) (IHC, x40). (c) Progesterone receptor positivity shown in the endometrial glands (hollow black arrow) and negativity in the stroma (asterisk) (IHC, x40). (d) Stromal tissue showing CD10 positivity (solid black arrow) (IHC, x40)
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F3
Histopathology of the biopsy revealed endometrial glands with rich vascularity [Figure 3(a)]. Further immunohistochemical studies with special stains revealed estrogen and progesterone receptor positivity in epithelial layer and CD10 positivity in stromal tissue [Figure 3(b-d)].