Marc H. Siegelbaum

Use of Immunohistochemistry for Identification of Primary Lymphoma of the Bladder

Primary lymphoma of the bladder is a rare entity, and when found in such an unusual location it frequently is difficult to distinguish between a lymphoma and an undifferentiated carcinoma. Immunohistochemical staining techniques have been used to identify tumor cell origins when the tissue type or a primary site of involvement is unknown. We report a case of primary lymphoma (nonHodgkins type) of the bladder and the use of immunohistochemical staining to distinguish definitively tissue type and then specific immunotype.

Congenital Pelvic Arteriovenous Malformation with Massive Prostatic Hemorrhage: A Case Report

Congenital arteriovenous malformations in the true pelvis are extremely rare: only 7 cases have been described in male patients. We report on a patient who presented with massive hemorrhage after transrectal prostatic biopsy and transurethral resection of the prostate. Diagnosis was established by means of magnetic resonance imaging and confirmed by arteriography. Our attempt at management by embolization and subsequent surgical ligation is described. A literature review and discussion of arteriovenous anomalies are presented.

Renoduodenal Fistula in a Patient with Chronic Nephrostomy Drainage: A Case Report

We describe the occurrence of a renoduodenal fistula related to a nephrostomy tube in a patient with xanthogranulomatous pyelonephritis and renal calculi. The patient was successfully treated by nephrectomy. Etiological, diagnostic and therapeutic aspects are discussed.

Renal infarction secondary tofibrous dysplasia and aneurysm formation of renal artery

We report a case of a previously healthy forty-year-old man with bilateral renal artery stenosis secondary to bilateral medial fibrous dysplasia. He was additionally found to have a dissecting aneurysm of the left upper renal artery branch with resultant infarction of the upper and middle pole renal segments. We believe renal infarction secondary to medial fibrous dysplasia with occlusion of the renal artery associated with a dissecting aneurysm has not been reported, and we report the first such case. A multimodality treatment approach was utilized.

Magnetic resonance imaging of papillary renal cell carcinoma

The authors report magnetic resonance (MR) studies in a case of papillary renal cell carcinoma. The preoperative ultrasound and computed tomographic scans suggested either a hemorrhagic cyst or a carcinoma, but the angiogram demonstrated avascularity. The magnetic resonance scan was more consistent with carcinoma than complicated cyst. We report the MR findings with pathologic correlation.

Delayed spontaneous resolution of high grade vesicoureteral reflux after reimplantation.

Significant (grade III/V or greater, International Reflux Study) postoperative vesicoureteral reflux was noted in 4 children who underwent technically satisfactory ureteral reimplantation. All patients had moderate to severe preoperative ureteral dilatation necessitating ureteral tapering in 3 of the 8 ureters reimplanted. Reoperation was considered in all 4 children but a conservative approach was used, with subsequent spontaneous resolution of the reflux 19 to 55 months after reimplantation. We conclude that even high grade reflux after satisfactory reimplantation can resolve spontaneously.

Venous Intravasation of Barium into the Inferior Mesenteric Vein Mimicking a Coloureteral Fistula: A Case Report and Literature Review

Venous intravasation of barium following a barium enema is a rare event. We report a case of barium venous intravasation into the inferior mesenteric vein. Because of the close proximity to the course of the left ureter, this condition was interpreted initially as a coloureteral fistula. After further analysis of the original films, and left retrograde pyelography the true diagnosis was established. A literature review of barium intravasation is presented.

Hydronephrosis secondary to colonic intussusception

We report on a two-month-old infant with bowel obstruction found to be secondary to a colonic intussusception (proved and reduced by barium enema). The finding of renal insufficiency prompted ultrasonographic renal evaluation uncovering a unilateral hydronephrosis. After resolution of the intussusception and hydration, the infants renal functions normalized. Follow-up ultrasound study and renal scan showed resolution of the hydronephrosis. We conclude that colonic intussusception can cause renal obstruction.