1
|
Ji X, Dong A, Zhu Y. Intraureteral Metastasis From Colon Cancer Mimicking Primary Ureteral Carcinoma on FDG PET/CT. Clin Nucl Med 2024:00003072-990000000-01160. [PMID: 38861423 DOI: 10.1097/rlu.0000000000005314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
ABSTRACT Hematogenous or lymphatic intraureteral metastasis from distant primary cancer is very rare. We present contrast-enhanced CT and FDG PET/CT findings in a case of intraureteral metastasis from colonic adenocarcinoma 3 years after colectomy. The intraureteral showed moderate enhancement on contrast-enhanced CT and increased FDG uptake on PET/CT mimicking a primary ureteral carcinoma. This case suggests that metastatic tumor of the ureter should be considered in the differential diagnosis in patients with hypermetabolic ureteral lesion and known malignancy.
Collapse
Affiliation(s)
- Xia Ji
- From the Department of Gastroenterology, The Second Affiliated Hospital, Jiaxing University, Jiaxing, Zhejiang Province, China
| | - Aisheng Dong
- Department of Nuclear Medicine, The First Affiliated Hospital of Naval Medical University, and
| | - Yan Zhu
- Department of Pathology, No. 905 Hospital of People's Liberation Army Navy and The First Affiliated Hospital of Naval Medical University, Shanghai, China
| |
Collapse
|
2
|
Chung J, Na JU, Lee JH, Han SK, Choi PC, Shin DH. Clinical study on ureteritis observed in contrast-enhanced computed tomography in the emergency department. Clin Exp Emerg Med 2022; 9:216-223. [PMID: 35926553 PMCID: PMC9561207 DOI: 10.15441/ceem.21.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 11/15/2021] [Indexed: 11/24/2022] Open
Abstract
Objective We aimed to investigate the causes and clinical and laboratory features of patients with ureteritis observed on intravenous contrast-enhanced abdominopelvic computed tomography (APCT) conducted in the emergency department (ED). Methods All APCTs conducted in the ED from November 2017 to November 2020 were investigated for the presence of ureteritis. The incidence of ureteritis, presumed cause of ureteritis, and clinical as well as laboratory features of patients with ureteritis were retrospectively analyzed. Results Ureteritis was observed in 422 out of 7,386 patients (5.7%) who underwent APCTs. The two main reasons for undergoing APCT in the ED were abdominal pain (49%) and infection focus workup (33%). The first major cause of ureteritis was urinary tract infection (UTI) (351 of 422, 83%). Most patients (85%) were febrile, but 208 (59%) exhibited no urinary symptoms such as dysuria, increased frequency, or residual urine sense. The second major cause of ureteritis was ureteral stones (42 of 422, 10%). Thirty-two of 42 patients (76%) had simple obstructive uropathy, while 24% of patients had a combined infection along with an obstruction. Other rare causes were malignancy and the spread of adjacent inflammation. Conclusion Ureteritis was a common finding observed in 5.7% of patients who underwent APCTs at the ED, and most of them were secondary to UTIs and ureteral stones. UTIs can cause ureteritis even without typical symptoms or signs suggestive of UTI, and diagnosis without an APCT can be difficult. More liberal use of APCTs should be considered when the cause of fever is difficult to diagnose.
Collapse
Affiliation(s)
- Jihyuk Chung
- Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Ung Na
- Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jang Hee Lee
- Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Kuk Han
- Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Pil Cho Choi
- Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Hyuk Shin
- Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
3
|
Zahid M, Nepal P, Nagar A, Batchala PP, Kumar D, Ojili V. Imaging of ureter: a primer for the emergency radiologist. Emerg Radiol 2021; 28:815-837. [PMID: 33851303 DOI: 10.1007/s10140-021-01930-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/29/2021] [Indexed: 11/28/2022]
Abstract
In this review article, we will discuss the gamut of abnormalities involving the ureters. In the emergency department, ureterolithiasis is the most common indication for imaging abdomen and pelvis. However, spectrum of ureteral abnormalities including congenital, infectious and inflammatory, primary and secondary ureteral malignancies, retroperitoneal fibrosis rare described in this article may be encountered. Thus, we will describe acute subacute as well as chronic conditions that may affect ureter. Knowledge of common, as well as rare entities and their imaging features, is of utmost importance to enable appropriate management.
Collapse
Affiliation(s)
- Mohd Zahid
- Department of Radiology, University of Alabama, Birmingham, AL, USA
| | - Pankaj Nepal
- Department of Radiology, St. Vincent's Medical Center, Bridgeport, CT, USA
| | - Arpit Nagar
- Department of Radiology, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Prem P Batchala
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA
| | - Devendra Kumar
- Department of Clinical Imaging, Al Wakra Hospital, Hamad Medical Corporation, Al Wakra, Qatar
| | - Vijayanadh Ojili
- Department of Radiology, University of Texas Health, San Antonio, TX, USA.
| |
Collapse
|
4
|
Moynihan MJ, Moinzadeh A, Mandeville JA. Symptomatic Ureteral Metastasis from Colon Adenocarcinoma. J Endourol Case Rep 2020; 6:80-82. [PMID: 32775684 DOI: 10.1089/cren.2019.0134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Symptomatic ureteral obstruction from a nonurologic metachronous metastatic malignancy is an unusual phenomenon that is underreported in the literature. This potential etiology for ureteral obstruction warrants consideration by the practicing urologist during a comprehensive evaluation as it may alter prognosis and management options for the afflicted patient. Case Presentation: An 80-year-old Caucasian man with a remote history of prostate cancer and colon cancer presented with new unilateral ureteral obstruction characterized by hydronephrosis, acute kidney injury, and right-sided abdominal pain. A high clinical index of suspicion ultimately leads to the diagnosis of metastatic colon cancer on ureteral biopsy specimen. Conclusion: Evaluation of symptomatic ureteral obstruction in a patient with a significant cancer history should include nonurologic malignant obstruction. Diligence in evaluation of the etiology of the ureteral stricture with repeat biopsies should be undertaken if there is clinical concern. Nephroureterectomy should be part of patient counseling for management of long segment malignant ureteral stricture disease.
Collapse
|
5
|
Karaosmanoglu AD, Onur MR, Karcaaltincaba M, Akata D, Ozmen MN. Secondary Tumors of the Urinary System: An Imaging Conundrum. Korean J Radiol 2018; 19:742-751. [PMID: 29962880 PMCID: PMC6005933 DOI: 10.3348/kjr.2018.19.4.742] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 12/29/2017] [Indexed: 01/20/2023] Open
Abstract
Imaging features of metastases to the urinary system may closely mimic primary urinary tract tumors, and differential diagnosis by imaging alone may be problematic or even impossible in some cases. The main purpose of this article was to familiarize radiologists with imaging findings of metastasis to the urinary system on cross-sectional imaging, with an emphasis on abdominal and pelvic computed tomography and magnetic resonance imaging. In addition, we review the clinical importance and implications of metastases to the urinary tract and provide information on diagnostic work-ups.
Collapse
Affiliation(s)
| | - Mehmet Ruhi Onur
- Department of Radiology, Hacettepe University, School of Medicine, Ankara 06230, Turkey
| | | | - Deniz Akata
- Department of Radiology, Hacettepe University, School of Medicine, Ankara 06230, Turkey
| | - Mustafa Nasuh Ozmen
- Department of Radiology, Hacettepe University, School of Medicine, Ankara 06230, Turkey
| |
Collapse
|
6
|
Moosavi B, Fasih N, Virmani V, Kielar A. Beyond ureterolithiasis: gamut of abnormalities affecting the ureter. Clin Imaging 2016; 40:678-90. [PMID: 27317212 DOI: 10.1016/j.clinimag.2016.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 12/08/2015] [Accepted: 01/06/2016] [Indexed: 12/31/2022]
Abstract
Nephrolithiasis is the most common condition involving the ureters. However, various other entities can affect the ureters, albeit less frequently. Imaging plays a crucial role in diagnosis, management, and follow-up of ureteral pathology. In the past decade, computed tomography urography has replaced traditional methods of ureteral imaging due to its high spatial resolution, multiplanar imaging, and rapid acquisition time. More recently, magnetic resonance urography has also been explored in evaluating ureteral abnormalities. In this review, we briefly discuss current imaging techniques used in assessment of the ureters and present a diverse group of diseases affecting the ureters. We begin with primary and secondary ureteral malignancies, followed by uncommon infectious/inflammatory diseases that can involve the ureters including tuberculosis, xanthogranulomatous pyelonephritis, and graft-versus-host disease. We then discuss the imaging characteristics of endometriosis and retroperitoneal fibrosis as two important examples of pelvic and retroperitoneal processes that occasionally obstruct the ureters and present with clinical symptoms similar to that of renal stones. We end with a brief discussion of miscellaneous conditions that affect the ureters, including ureteral hemorrhage, ureteral intussusception, ureteral pseudodiverticulosis, Malacoplakia, and ureteritis cystica. Knowledge of these entities and their characteristic imaging manifestations along with patient's clinical presentation allows accurate diagnosis and timely patient management.
Collapse
Affiliation(s)
- Bardia Moosavi
- The Ottawa hospital, Department of Radiology Civic Campus, 1053 Carling Avenue, Room C120, Ottawa, ON, K1T4E9.
| | - Najla Fasih
- The Ottawa hospital, Department of Radiology, 501 Smyth Road, Ottawa, ON, K1H 8L6.
| | - Vivek Virmani
- The Ottawa hospital, Department of Radiology, 501 Smyth Road, Ottawa, ON, K1H 8L6.
| | - Ania Kielar
- The Ottawa hospital, Department of Radiology, 501 Smyth Road, Ottawa, ON, K1H 8L6.
| |
Collapse
|
7
|
Foote C, Henderson S, Reddy S, Horrow M, Leighton J, Cahn D, Diorio G, Bickell M, Ginsberg P, Metro M. Primary Ureteral Lymphoma Presenting with Acute Flank Pain. Curr Urol 2015. [PMID: 26195954 DOI: 10.1159/000365679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Non-Hodgkin's lymphoma (NHL) represents 4% of newly diagnosed cancer in 2013 with a 59-82% 5-year survival depending on the tumor location. Primary presentation of lymphoma consists of lymphadenopathy or swelling of the lymph nodes and non-specific systemic symptoms such as fevers, night sweats, and weight loss. Less commonly, NHL arises from non-lymphoid tissue. We report a unique case of NHL arising from the ureteral wall which was visualized via non-contrast CT and direct vision through ureteroscopy.
Collapse
Affiliation(s)
| | | | - Shilpa Reddy
- Albert Einstein Medical Center, Philadelphia, PA, USA
| | - Mindy Horrow
- Albert Einstein Medical Center, Philadelphia, PA, USA
| | - John Leighton
- Albert Einstein Medical Center, Philadelphia, PA, USA
| | - David Cahn
- Albert Einstein Medical Center, Philadelphia, PA, USA
| | - Greg Diorio
- Albert Einstein Medical Center, Philadelphia, PA, USA
| | | | | | - Michael Metro
- Albert Einstein Medical Center, Philadelphia, PA, USA
| |
Collapse
|
8
|
Salem AB, Nfoussi H, Kchir N. Ureteral spread of a primary cutaneous diffuse large B-cell lymphoma, leg type. Indian J Urol 2014; 30:222-4. [PMID: 24744525 PMCID: PMC3989828 DOI: 10.4103/0970-1591.126912] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We report a case of 76-year-old man, with a past medical history of primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT), who presented with ureteral tumor diagnosed as urothelial carcinoma on imaging investigations. Histological examination showed an unusual finding. The tumor was a ureteral localization of the PCDLBCL-LT previously diagnosed. To the best of our knowledge, this is the first case of PCDLBCL-LT with ureteral spread described in the literature.
Collapse
Affiliation(s)
- Amira Ben Salem
- Department of Pathology, La Rabta Hospital of Tunis, Tunis, Tunisia
| | - Haifa Nfoussi
- Department of Pathology, La Rabta Hospital of Tunis, Tunis, Tunisia
| | - Nidham Kchir
- Department of Pathology, La Rabta Hospital of Tunis, Tunis, Tunisia
| |
Collapse
|
9
|
Abstract
OBJECTIVES This study aims to evaluate whether (18)F-FDG excretion patterns reflect renal function in malignant obstructive uropathy and to evaluate if these patterns predict internal ureteral stent success. METHODS One hundred twelve patients who underwent PET/CT for abdominal tumors and displayed hydronephrosis on CT and 59 patients who underwent PET/CT for cancer screening were included in a retrospective study. Hydronephrosis was graded by initial CT and correlated with visual analysis of (18)F-FDG renal parenchymal uptake and excretion patterns. Stent insertion was performed for 84 patients after PET. Follow-up CT was reviewed for hydronephrosis improvement. RESULTS There were 4 PET patterns in obstructive hydronephrosis which correlated linearly with hydronephrosis severity and serum creatinine levels. Patients with no parenchymal retention and renal excretion (PET pattern 1) showed 97% (28/29) hydronephrosis improvement after stent insertion, and patients with no parenchymal retention and no renal excretion showed 0% (0/9) hydronephrosis improvement after stent insertion. Multivariate analysis showed creatinine levels and PET pattern predicted stent success, but CT hydronephrosis did not. CONCLUSIONS There are 4 PET patterns of obstructive hydronephrosis which correlated with hydronephrosis grade and creatinine levels. Some of these PET patterns can be useful in the prediction of hydronephrosis improvement after stent insertion. Recognition of these patterns in obstructive hydronephrosis may be helpful in improving patient prognosis and quality of life.
Collapse
|
10
|
[Ureteral metastasis of prostatic adenocarcinoma: case report and literature review]. Prog Urol 2013; 23:1443-8. [PMID: 24274950 DOI: 10.1016/j.purol.2013.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 04/29/2013] [Accepted: 05/02/2013] [Indexed: 12/24/2022]
Abstract
Ureteral metastases of prostatic adenocarcinoma are very rare. We report the case of a 66-year-old man with a right ureteral metastasis of prostate cancer. Only 10 cases have been reported in the literature these last 30 years. Most patients had a multimetastatic prostate cancer. Local treatment is not standardized. Hormonotherapy seems to be the most appropriate treatment in first intention.
Collapse
|
11
|
Rosenberg S, Katz R, Pode D, Gofrit NO, Pizov G, Hovav N. An ALK translocation positive carcinoma of the lung presenting as uremia due to bilateral renal obstruction. Can Urol Assoc J 2013; 7:E490-4. [PMID: 23914266 DOI: 10.5489/cuaj.172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We describe an unusual presentation of metastatic lung adenocarcinoma as malignant retroperitoneal fibrosis (MRPF). The diagnostic challenge, due to the small solitary lung mass and absence of a discrete retroperitoneal mass, was overcome by diagnostic laparoscopy. Molecular analysis of tissue acquired was positive for ALK gene rearrangement. Treatment of the patient with crizotinib reversed MRPF. He was weaned off the nephrostomy tubes and is with stable renal function 11 months after diagnosis.
Collapse
Affiliation(s)
- Shilo Rosenberg
- Department of Urology, Hadassah-Hebrew University Medical Center Jerusalem, Israel
| | | | | | | | | | | |
Collapse
|
12
|
Bhargava P, Dighe MK, Lee JH, Wang C. Multimodality Imaging of Ureteric Disease. Radiol Clin North Am 2012; 50:271-99, vi. [DOI: 10.1016/j.rcl.2012.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
13
|
Darrad M, Harper S, Verghese A, Leveckis J, Pathak S. Synchronous and metachronous ureteric metastases from adenocarcinoma of the colon. Int J Clin Oncol 2011; 17:185-8. [PMID: 21710156 DOI: 10.1007/s10147-011-0274-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Accepted: 06/07/2011] [Indexed: 01/16/2023]
Abstract
Primary adenocarcinoma of the ureter occurs in only <1%. Furthermore, metastatic carcinoma to the ureter is very rare and has been described to occur from breast, lung, stomach and prostate cancers. However, metastases to the ureter from colon cancers are extremely rare, and have been largely reported as incidental post-mortem cases. We describe two cases of asymptomatic ureteric metastases secondary to adenocarcinoma of the colon; one is synchronous, whilst the other is a metachronous ureteric metastasis. With the increasing use of radiological imaging modalities such as CT and MRI (Clin Imaging 2001;25:197-202, 2001), together with increasing survival rates of primary cancers, asymptomatic ureteric metastases are more likely to be diagnosed. In summary, metastatic ureteric carcinoma of colonic origin must be considered as a differential diagnosis when there is a radiological abnormality of the ureter in patients with a history of adenocarcinoma of the colon. This should be considered even in patients with colon adenocarcinoma who have previously undergone adjuvant chemotherapy with curative intent.
Collapse
Affiliation(s)
- Maitrey Darrad
- Department of Urology, Doncaster Royal Infirmary, Armthorpe Road, Doncaster, DN2 5LT, UK
| | | | | | | | | |
Collapse
|
14
|
Metastatic ureteral involvement of non-small cell lung cancer. Case Rep Med 2011; 2011:394326. [PMID: 21541230 PMCID: PMC3085393 DOI: 10.1155/2011/394326] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2010] [Accepted: 02/01/2011] [Indexed: 11/17/2022] Open
Abstract
Metastases from a variety of malignant tumors can involve the ureters, but ureteral involvement by lung cancer is extremely rare and usually described at autopsy. We report a rare case of a 76-year-old man who presented with a three-month history of right flank dullness and was noted to have a nonhomogeneous retroperitoneal mass with hydronephrosis of the right kidney on computed tomography of the abdomen. Computed tomography of the thorax showed a nodule in the lower lobe, measuring 3 × 2 cm, in the right lung. After excluding the presence of other primary tumors and metastases, we reached a final diagnosis of solitary retroperitoneal metastasis of adenocarcinoma of the lung. Although rare, in patients of non-small cell lung cancer, presence of hydronephrosis should alert the physician to the possibility of metastasis.
Collapse
|
15
|
Thorup B, Fabrin K, Lund L. Implantation metastasis in ureter from a colonic adenocarcinoma. SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY 2001; 35:420-1. [PMID: 11771872 DOI: 10.1080/003655901753224512] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Metastasis to the ureter is very rare. In most published cases, the diagnosis is only made at postmortem examination or when gross metastasis is present. This report presents a case in which the metastasis from a colonic tumour occluded the ureteral lumen from inside.
Collapse
Affiliation(s)
- B Thorup
- Department of Surgery, Viborg Hospital, Denmark
| | | | | |
Collapse
|
16
|
Connor SE, Umaria N, Guest PJ. Case report: Extranodal peripelvic and periureteric lymphoma--demonstration with computed tomography. Clin Radiol 2001; 56:422-4. [PMID: 11384144 DOI: 10.1053/crad.1999.0285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- S E Connor
- Department of Clinical Radiology, Queen Elizabeth Hospital, Birmingham, West Midlands B15 2TH, U.K
| | | | | |
Collapse
|
17
|
Menéndez V, Sala X, Alvarez-Vijande R, Solé M, Rodriguez A, Carretero P. Cystic pyeloureteritis: review of 34 cases. Radiologic aspects and differential diagnosis. Urology 1997; 50:31-7. [PMID: 9218015 DOI: 10.1016/s0090-4295(97)00205-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To refine the clinical and radiologic description of an unusual benign disease, cystic pyeloureteritis (CPU), consisting of the appearance of suburothelial cysts that raise the mucosa layer of the urothelium. We also studied its relationship with various types of inflammation, including chronic infection, that may be the stimulus for the appearance of CPU. METHODS We compiled 34 cases of CPU covering the period 1976 to 1994, analyzing the clinical manifestations, diagnostic procedures, differential diagnosis, and evolution. RESULTS There are no specific symptoms associated with the presence of cysts. The average age of the patients was 59 years (range 30 to 77). Urinary tract infection was detected in 18 (53%). The pyeloureteritis was unilateral in 27 (79%) and bilateral in 7 (21%) of the patients. The location of the cysts was as follows: 1 pyelic (3%); 6 pyeloureteral (18%); and 27 (79%) ureteral. Resolution of the radiologic alterations depends on the resolution of the associated pathology: infections, lithiasis, and obstruction. CONCLUSIONS We conclude that CPU is a benign pathology with indolent evolution and variable duration; it is not associated with sequelae. Diagnosis is made on the basis of radiologic findings, mainly intravenous urography; in view of the minor entity of the pathology, biopsy is not advisable if the radiologic findings are conclusive.
Collapse
Affiliation(s)
- V Menéndez
- Department of Urology, University of Barcelona, Spain
| | | | | | | | | | | |
Collapse
|
18
|
Lebowitz JA, Rofsky NM, Weinreb JC, Friedmann P. Ureteral lymphoma: MRI demonstration. ABDOMINAL IMAGING 1995; 20:173-5. [PMID: 7787726 DOI: 10.1007/bf00201532] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A case of ureteral lymphoma with no other areas of involvement was incidentally discovered on MRI examination. Bilateral ureteral soft tissue infiltration, asymmetrical hydronephrosis, and abnormal enhancement of lymphomatous tissue were noted. A follow-up MRI after chemotherapy demonstrated significant decrease in the size of the periureteral disease and improvement in the extent of hydronephrosis.
Collapse
Affiliation(s)
- J A Lebowitz
- Department of Radiology, New York University Medical Center, NY 10016, USA
| | | | | | | |
Collapse
|
19
|
Wasserman NF. Pseudodiverticulosis: unusual appearance for metastases to the ureter. ABDOMINAL IMAGING 1994; 19:376-8. [PMID: 8075570 DOI: 10.1007/bf00198204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A rare pseudodiverticular pattern of metastatic malignancy to the ureter is reported along with pathologic findings at postmortem examination in three patients. There was no clinical or pathological obstruction. This pattern is due to malignancy-induced edema in the subepithelial connective tissues and muscularis propria causing displacement of these layers into the ureteral lumen resulting in an undulating epithelial surface. The epithelium itself is normal. Metastases to the ureter is uncommon in life unless associated with ureteral obstruction. Ureteral pseudodiverticulosis found in vivo in a nonobstructed patient with known metastatic malignancy is likely due to inflammatory causes and usually reversible with antibiotic and medical therapy. A patient with widespread malignancy showing nonreversibility of the ureteral pseudodiverticular pattern, even in the absence of obstruction, should be considered a candidate for impending obstruction and followed closely for ureteral stent placement.
Collapse
Affiliation(s)
- N F Wasserman
- Department of Radiology (114), Department of Veterans Affairs Medical Center, Minneapolis, Minnesota 55417
| |
Collapse
|