PMC5140873_01
Magnetic resonance angiography of the abdominal lesion and renal scintigraphy. A: Magnetic resonance angiography of the abdominal lesion showed an obstruction at the origin of the left renal artery (arrow). B: Renal scintigraphy with technetium-99m diethylene triamine pentaacetic acid (99mTc-DTPA) showed a weak accumulation, and the uptake in the left renal artery was much weaker (arrow).
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In the previous hospital, an obstruction at the origin of the left renal artery was detected by magnetic resonance angiography (MRA) and renal scintigraphy (Fig. 1).
Macroscopic findings of the abdominal aorta. A: The wall was irregularly thick and the lumen was rough. B: Contrast-enhanced computed tomography of the abdomen on the 16th hospital day showed the irregular wall of the abdominal aorta (circle). C: Both the renal arteries (*1: right, *2: left) and celiac artery (*3) were occluded at the origin. *4: superior mesenteric artery.
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The wall of the abdominal aorta was irregularly thick and its lumen was rough (Fig. 2A). When we carefully reviewed the contrast-enhanced CT scan of the 1st perforation, we found that it showed an irregular lumen in the aorta (Fig. 2B) and corresponded with the anatomical findings. The origin of the celiac artery and both renal arteries was occluded (Fig. 2C) with cells of similar morphology (Fig. 3C and D).
Histological findings. A: Spindle and ovoid cells with hyperchromatic nuclei proliferated in the superficial lumen of the abdominal aorta (Hematoxylin and Eosin (H&E) staining 20x, B: 400x). C: Spindle and ovoid cells with hyperchromatic nuclei were also observed in the left renal artery (H&E staining 20x, D: 400x).
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The superficial layer of the lumen was composed of spindle and ovoid cells with hyperchromatic nuclei (Fig. 3A and B).