PMC6590521_01
Pathological examination. (a) The primary tumor of her left shoulder demonstrated the sheets of differentiated cartilage cells. (b) Immunohistochemical staining showed positive for toluidine blue reflecting cartilage cells containing acidic mucopolysaccharide. (c) Pathological examination in the kidney was similar to that in the primary tumor of her left shoulder.
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fig1
The tumor was composed of cartilage cells growing a lobular architecture with eosinophilic reticulum and myxoid stromal tissue and was diagnosed as Grade 2 chondrosarcoma (Figure 1(a)). Considering the primary tumor pathological findings, we hypothesized that the tumor was composed of cartilage cells with a high cell density and enlarged nuclei (Figure 1(a)). The tumor cells were positive for toluidine blue staining, confirming a cartilaginous component (Figure 1(b)). The kidney tumor was also diagnosed as Grade 2 chondrosarcoma (Figure 1(c)).
(a) CT scan demonstrated a cyst in the upper half of the right kidney and no septa or calcifications (arrow). (b) T2-weighted MRI showed a cystic tumor with a high signal (arrow). (c) Diffusion-weighted MRI (DW-MRI) showed rim enhancement (arrow).
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fig2
No septa or calcifications were observed in the tumor (Figure 2(a)). Contrast-enhanced images showed a thick, slightly enhanced cystic wall, and the tumor was classified as a Bosniak IIF cystic renal lesion (Figure 2(b)).
On retrograde pyelography, an incomplete double ureter was showed and a solitary filling defect was observed in the upper pole of the right renal pelvis (arrow).
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fig3
Retrograde pyelography demonstrated a solitary filling defect in the upper pole of the right renal pelvis (Figure 3).
Urine cytology demonstrated low-grade malignant cells with a mucus-like substance (x400).
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fig4
Urine cytology demonstrated low-grade malignant cells with a light green stained large reticulum and a mucus-like substance (Figure 4).
Tumor located in the upper pole with invasion into the renal pelvis.
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fig5
The tumor involved the renal pelvis, and the cut surface of the tumor was white and jelly-like (Figure 5).