Sitomorfolojik Bulgularla Pelvis Renalisin Üroteryal Neoplazmı

Abstract

İdrar sitolojisi, sıklıkla mesanede izlenen üroteryal neoplaziler için kullanılan önemli bir tanısal tekniktir. Pelvikaliksiyel sistem ve üreter tümörlerinin tanısında sitopatolojik kanıtları ortaya koymak daha zor olmakla beraber sitolojik materyalde tümörün tanısı ve derecelendirilmesi, tedavi planlanmasında önemli avantaj sağlar. Gross hematüri etyolojisi araştırılan 55 yaşında erkek hastanın, abdomen bilgisayarlı tomografisinde “sağ pelvis renalisde tümör?” saptanması üzerine yapılan üreterorenoskopisinde, pelvis renalisde multipl papiller kitle görünümü izlenmiştir. Bu işlem sırasında alınan idrar sitolojisi “malignite şüphesi” gösteren yayma olarak rapor edilmiştir. Doku örnekleri kesitlerinde, fibrovasküler kor çevresinde dizilim gösteren 6–7 epitel hücre tabakasından oluşan papiller yapılar ile karakterize tümöral oluşum izlenmiştir. Tümör, pleomorfik, iri, nükleolleri belirgin, hiperkromatik nükleuslu, eozinofilik sitoplazmalı atipik epitelyal karakterde hücrelerden oluşmaktadır. Lamina propriada invazyon saptanmayan olgu “düşük malign potansiyelli papiller üroteryal neoplazi (WHO/ISUP 98)” tanısı almıştır. Olgumuz diyagnostik sitolojik özellikleri nedeniyle sunulmaya değer bulunmuştur. Urothelial neoplasm of pelvis renalis with cytomorphology findings Urine cytology is an important diagnostic technique for urothelial neoplasia. Although it is difficult to demonstrate the cytopathological clues in the diagnos are of pelvicalicial system and urothelial tumors, tumor grading and diagnosis with cytology provides important advantages for treatment. After “right pelvis renalis tumor?” determination in abdominal computerized tomography of a 55 year old male patient for gross hematuria etiology search, multiple milimetric papillary mass appearance was observed at pelvis renalis in ureterorenoscopy. In examination of urine sample obtained during this procedure reported as “suspicious of malignancy”. A tumoral mass characterized with papillary structures composed of 6-7 epithelial cells layer lined around fibrovasculary core, is designated in cross sections. Tumor was composed of atypical epithelial cells with pleomorphic, coarse, apparent nucleoli, hyperchromatic nuclei and eosynophilic cytoplasm features. Tumor with no lamina propria invasion reported as “papillary urothelial neoplasm with low malignancy potential (WHO/ISSUP 98)” Our case was worth presentation because of its diagnostic cytological features.

Keywords

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