Short Case Report
Leukoplakia of Renal Pelvis Case Report A female patient, aged 65, was operated upon twice
because of nephrolithiasis in 1940 and in 1971.2 years after the second operation she again began to complain of left renal colic. A whitish substance was passed in the urine during some of these attacks; this was examined histopathologically and found to be formed o f keratin. The diagnosis of leukoplakia of the kidney was therefore suspected. I V P performed during one of the attacks showed a non-homogeneous cotton-wool tilling defect in the left pelvis (Fig. I). Since the disease is considered to be precancerous, a left nephrectoniy was carried out. On microscopic examination the Inucosa of the renal pelvis showed nietaplasia to stratified squarnous epithelium. The eDitheliuni was built UD with afew lavers of pricklecells and covered with a thjck layer of keratin several times the thickness of the epithelium (Fig. 2).
Fig. 1. Nephrotomography performed during ;in attach o f renal colic showing the typical filling dctect iii the p e l \ i \
o f the left kidney. The kidney shows sign5 of chronic pyelonephrotis.
Comment
Leukoplakia of the renal pelvis (cholesteatoma) is an uncommon disease. Pathologically i t is manifested as a metaplasia of the transitional epithelium of the urinary tract into squamous epithelium with cornification. I t appears to be a response to the irritation associated with infection. Stones are known to be present long before the clinical picture of leukoplakia appears. The passage of sheets of desquamated squamous epithelial cells, usually during a n attack of renal colic, is pathognomonic‘The disorder is ‘Onsidered to be precancerous and in unilateral cases the treatment of choice is nephrectomy.
Fig.2. Renal pelvis. Metaplasia ofthe inticosa tu \tratilicd squanious epithelium with marked heriitinisation. H.E. x 2 5 0 .
Reference
J . FISCHELOVITCH and IRINA AVIDOR Director ofthe Department of Urology, Eniek Medical Centre, Afrila, Israel, and J . Casper Institute of P ~ t l i o l o g ~Beilinson ~, Medical Centre, Petah Tikva, Isrriel
B. A. Jr., WEBB,E. A. and PRict, W. E. (1962). Renal leukoplakia : observations of Ixhnviour, Jorirncrl oJ. Urokogy, 87, 279-281.
SMiTH,
316
Leukoplakia of Renal Pelvis Case Report A female patient, aged 65, was operated upon twice
because of nephrolithiasis in 1940 and in 1971.2 years after the second operation she again began to complain of left renal colic. A whitish substance was passed in the urine during some of these attacks; this was examined histopathologically and found to be formed o f keratin. The diagnosis of leukoplakia of the kidney was therefore suspected. I V P performed during one of the attacks showed a non-homogeneous cotton-wool tilling defect in the left pelvis (Fig. I). Since the disease is considered to be precancerous, a left nephrectoniy was carried out. On microscopic examination the Inucosa of the renal pelvis showed nietaplasia to stratified squarnous epithelium. The eDitheliuni was built UD with afew lavers of pricklecells and covered with a thjck layer of keratin several times the thickness of the epithelium (Fig. 2).
Fig. 1. Nephrotomography performed during ;in attach o f renal colic showing the typical filling dctect iii the p e l \ i \
o f the left kidney. The kidney shows sign5 of chronic pyelonephrotis.
Comment
Leukoplakia of the renal pelvis (cholesteatoma) is an uncommon disease. Pathologically i t is manifested as a metaplasia of the transitional epithelium of the urinary tract into squamous epithelium with cornification. I t appears to be a response to the irritation associated with infection. Stones are known to be present long before the clinical picture of leukoplakia appears. The passage of sheets of desquamated squamous epithelial cells, usually during a n attack of renal colic, is pathognomonic‘The disorder is ‘Onsidered to be precancerous and in unilateral cases the treatment of choice is nephrectomy.
Fig.2. Renal pelvis. Metaplasia ofthe inticosa tu \tratilicd squanious epithelium with marked heriitinisation. H.E. x 2 5 0 .
Reference
J . FISCHELOVITCH and IRINA AVIDOR Director ofthe Department of Urology, Eniek Medical Centre, Afrila, Israel, and J . Casper Institute of P ~ t l i o l o g ~Beilinson ~, Medical Centre, Petah Tikva, Isrriel
B. A. Jr., WEBB,E. A. and PRict, W. E. (1962). Renal leukoplakia : observations of Ixhnviour, Jorirncrl oJ. Urokogy, 87, 279-281.
SMiTH,
316
