111 renal neoplasms of childhood: a clinicopathologic study

Primary Pure Intrarenal Yolk Sac Tumor in 1.5-Year-Old Boy-A Rare Case Report

Germ cell tumors primarily arise in gonads and extragonadal germ cell tumors, an uncommon entity, originates usually along the midline. Here, we report the fifth example of intrarenal pure yolk sac tumor in a 1.5-year-old boy who presented with abdominal pain and underwent excision of the mass for suspected Wilms tumor. On histopathology and immunohistochemistry, a diagnosis of a yolk sac tumor was rendered. Postoperative serum alpha-fetoprotein levels were 21 000 ng/dl. The purpose of this report is to emphasize the importance of suspecting a germ cell tumor as one of the differential diagnoses of a suspected case of Wilms tumor and the significance of evaluating serum alpha-fetoprotein levels preoperatively.

CT findings of intrarenal yolk sac tumor with tumor thrombus extending into the inferior vena cava: a case report

Yolk sac tumor (YST) is a rare germ cell neoplasm of childhood that usually arises from the testis or ovary. The rare cases of YST in various extragonadal locations have been reported, but the primary intrarenal YST is even more uncommon. Here, we report a case of a primary intrarenal YST with tumor thrombus of the inferior vena cava and left renal vein in a 2-year-old boy, with an emphasis on the CT features. To our knowledge, this is the first reported case of an intrarenal YST with intravascular involvement.

Immunohistochemical Study of Porcine Nephroblastoma

Nephroblastoma, a relatively common renal neoplasm of young swine, represents the animal counterpart of Wilms' tumour of children. Five porcine nephroblastomas were examined histologically, and immunohistochemically with antibodies against vimentin (VIM), cytokeratins (CKs), smooth-muscle actin, Factor VIII, and laminin. Histologically all showed the three components typical of this tumour: mesenchymal blastema, epithelium (tubuli, and glomeruloid bodies) and stroma. The only antibody recognizing mesenchymal cells was VIM. One-third of tubular structures were positive for VIM. All of the tubules were positive for CK19, two-thirds expressed CK AE1/AE3, and only one-third expressed CKs 8-18. Small round tubuli, located in the stromal septa, were positive for CK7 (ureteric branches). Stromal cells expressed both VIM and actin, demonstrating myofibroblastic differentiation. The kidney originates from mesenchymal blastema, which changes to epithelium, losing VIM and acquiring CK expression. In the adult mammalian kidney, CK 19 is expressed only by the parietal epithelium of Bowman's capsule and the distal tubules. Nevertheless, CK19 is also considered a "transient" CK, expressed by different kinds of epithelia during differentiation. CK 19 was also detected in several undifferentiated neoplasms. This finding, together with the co-expression of VIM detected in some tubules, demonstrates the embryonic origin of nephroblastoma.