Case Of Juxtaglomerular Cell Tumor Research Articles

Newly developed hypertension due to juxtaglomerular cell tumor in pregnancy

An unusual case of juxtaglomerular cell tumor (JCT) is presented. A 29-year-old woman visited our hospital for the management of incidentally detected renal mass due to newly developed hypertension in the 20th week of pregnancy. Laboratory studies showed increased basal plasma renin activity and hypokalemia but serum aldosterone level was normal. Abdominal computed tomography scan showed about 2.4 cm sized multicystic mass in the right kidney. Nephron-sparing surgery was performed with excellent results. On histological examination, the tumor exhibited a structure typical feature of JCT. A few days later the patient's blood pressure had been normalized.

A case of juxtaglomerular cell tumor (reninoma) of the kidney treated with laparoscopic partial nephrectomy

A 23-year-old woman was referred to our hospital with persistent hypertension over 5 years irrespective of medication. Her blood pressure on admission was 210/130 mm HG. She had no family history of hypertension. Biochemical evaluation revealed hypo-potassium (2.7 mEq/L) and a high concentration of plasma rennin activity (20.6 ng/mL/h). An abdominal computed tomography scan showed 1-cm iso-density, and a weak contrast-enhancing solid mass in the right kidney cortex (Fig. 1a). Magnetic resonance imaging (MRI) with and without gadolinium showed a well-defined iso-intensity mass in the right kidney by T1 weighted image. The mass showed lowintensity in fat saturation T2-weighted image with weak contrast-enhancement, and high-intensity in diffusion magnetic resonance imaging (MRI) (Fig. 1b). This MRI finding was suggestive of reninoma. Although selective venous sampling failed to show any significant difference in the rennin activity between the right and left renal vein, it was highly suspected that this kidney tumor was producing rennin. After the patient’s written informed consent was obtained, the right kidney tumor was removed by laparoscopic partial nephrectomy. The tumor was well-capsulated and its cutting surface was white. Histological and immunohistochemical examinations revealed that the tumor had inconspicuous nuclear morphism and plenty of rennin granules in the cytoplasm (Fig. 1c). Two hours after tumor removal, the concentrations of plasma rennin and aldosterone were normalized. A few days after the operation, the patient’s blood pressure had been normalized. Reninoma should be considered when hypertension is uncontrollable with hypo-potassium. As far as we know, only 89 cases of reninoma have been reported. This is the third patient who was successfully treated with laparoscopic partial nephrectomy.

Juxtaglomerular Cell Tumor of the Kidney: Case Report and Differential Diagnosis With Emphasis on Pathologic and Cytopathologic Features

This study presents a case of juxtaglomerular cell tumor (JCT) in a 12-year-old girl with hypertension. Fine needle aspirate (FNA) cytology demonstrated a neoplasm with features of a papillary carcinoma, prompting a right radical nephrectomy. Histological examination revealed solid sheets of round epithelioid cells with eosinophilic granular cytoplasm, and distinct cell borders in a background of widespread hemorrhage. Electron microscopy revealed cytoplasmic renin granules. The differential diagnosis of a renal mass in a young patient with hypertension includes JCT, Wilm's tumor, and renal cell carcinoma, which may produce renin. The renin granules detected by electron microscopy are characteristic of JCT, and the diagnosis is confirmed by ultrastructural study. FNA cytology is not sensitive enough for the diagnosis of JCT and its results must be carefully interpreted.

Malignant Hypertension With Intestinal Ischemia Secondary to Juxtaglomerular Cell Tumor

Malignant hypertension is a well-defined condition associated with high blood pressure and acute target-organ damage. Although 95% of cases are secondary to essential hypertension, its etiological profile is broad. Juxtaglomerular cell tumor is a rare condition, with only approximately 65 cases reported to date. We describe a patient with malignant hypertension with acute renal failure and intestinal ischemia secondary to a juxtaglomerular cell tumor. We believe this is the first case of juxtaglomerular cell tumor causing malignant hypertension. The diagnostic approach and treatment are discussed.

Juxtaglomerular Cell Tumor of the Kidney

We present a case of juxtaglomerular cell tumor (JGCT) that developed in a 44-year-old woman with hypertension, which subsided after the tumor was removed. The tumor was 8.5 cm in greatest dimension and is thought to be the largest such tumor reported to date. Ultrastructural study confirmed the diagnosis of JGCT by the demonstration of the typical cytoplasmic rhomboidal secretory granules on electron microscopy. The tumor cells were also strongly reactive for CD34, a finding that has not been previously reported and that may be an adjunct to the diagnosis of JGCT in a patient with hypertension, hyperreninemia, and/or hypokalemia. At present, however, further studies on additional cases for CD34 expression will be necessary to fully evaluate the diagnostic utility of this marker in the diagnosing of JGCT.

傍糸球体細胞腫の1例

We present a case of juxtaglomerular cell tumor measuring 8 mm in diameter in the right kidney. The hypertension was cured and plasma renin activity returned to normal level following tumor resection with partial nephrectomy. We studied histopathologic, electron microscopic, and immunohistochemical findings of the tumor. The majority of tumor cells stores renin granules in cytoplasm. In situ hybridization confirmed us that the most tumor cells produce renin. We use the digoxigenin labeled 0.6-kb length RNA probe of human renal renin, the specificity was analyzed by competition assay (1:50).

J14 A case of juxtaglomerular cell tumor (reninoma): Diagnostic methods and treatment

J14 A case of juxtaglomerular cell tumor (reninoma): Diagnostic methods and treatment

An Immunohistochemical, Electron-microscopic, and in situ Hybridization Study

We present a case of juxtaglomerular cell tumor (JCT) in a 10-year-old boy. The child suffered from severe hypertension that returned to normal following the tumor resection. The diagnosis of JCT was supported by electron-microscopic findings of typical rhomboid secretory granules and by immunohistochemistry using a polyclonal antibody against active and inactive forms of renin. The production of renin by the tumor cells was confirmed by demonstration of specific renin mRNA by in situ hybridization (ISH). The immunohistochemistry also showed a weak positivity of renin in the media of interlobular arteries and in the epithelial cells of proximal tubules. The ISH was negative for renin mRNA at these sites, indicating that renin positivity was due to an uptake of renin rather than to renin production. The juxtaglomerular apparatuses in the adjacent renal cortex were negative for renin, suggesting a compensatory inhibition mechanism by the hyperreninemia. The tumor was encapsulated by a fibrous tissue, but the capsule was penetrated by clusters of the tumor cells--an indication of the tumor's invasive capability.

A Case of Juxtaglomerular Cell Tumor Diagnosed Preoperatively

A case of juxtaglomerular cell tumor, the fourth case in the world diagnosed preoperatively, was reported. Neither strict sodium restriction nor loading of upright position increased a grade of hyperreninemia observed at recumbant position on ordinary diet, but Pald elevated in response to them. Abnormal glucose tolerance was considered to be due to hypopotassemia. Selective renal arteriography revealed a small number of tumor vessels, a lucent area on the nephrogram and early appearance of the renal vein of the diseased side. Histologically, the tumor contained some canalicular structures among the polygonal nonepithelial tumor cells with rhomboid bodies. These findings suggested that this tumor was a hamartoma originated from the juxtaglomerular apparatus.