PMC6033302_01
Right hydronephrosis secondary to a right ureteral mass.
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A 79-year-old man with a distant history of colon cancer treated with surgery and radiation and diffuse large B cell lymphoma presented with asymptomatic right hydroureteronephrosis to the level of the mid-ureter with associated right ureteral wall thickening found on surveillance CT scan for lymphoma (Fig. 1).
Retrograde pyelography showing right ureteral mass with goblet sign (arrow).
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Repeat biopsies through retrograde ureteroscopy (Figs. 2 and 3) showed similar changes with rare small tubular structures within a fibromyxoid stromal background.
Intraoperative picture of right ureteral mass during retrograde ureteroscopy.
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Repeat biopsies through retrograde ureteroscopy (Figs. 2 and 3) showed similar changes with rare small tubular structures within a fibromyxoid stromal background.
Histologic images of fibromyxoid nephrogenic adenoma. Both cases (case 1, A-C and case 2, D-F) showed rare minute tubular structures within an abundant fibromyxoid stroma. Note the bland cytologic features (E) with low nuclear-cytoplasmic ratio and lack of hyperchromasia and pleomorphism. Nuclear expression of PAX-8 was present by immunohistochemistry (C, E). Magnification, A-D, x 100; E, F, x200.
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Repeat immunohistochemical studies showed the small glands to stain positively with PAX8, highlighting rare foci of nephrogenic adenoma of the fibromyxoid type (Fig. 4).
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