No abstract available.
Adenoma, Oxyphilic*

Adrenal oncocytomas are rare adrenal neoplasms which are usually large and nonfunctioning. Most of them are benign. We report a rare case of adrenal oncocytoma presenting with bilateral gynaecomastia and hypogonadism in 67-year- old male from Myanmar who had elevated estradiol levels. He successfully underwent an adrenalectomy and the histologic diagnosis was an oncocytoma. The immunohistochemical (IHC) staining was positive for neuron specific enolase (NSE), vimentin and synaptophysin. Feminizing adrenal oncocytoma has not been reported in literature.
Adenoma, Oxyphilic

PURPOSE: To radiologically differentiate renal oncocytoma from other renal solid tumors, we analyzed and characterized, retrogradely, radiologic findings of renal oncocytomas. MATERIALS AND METHODS: Radiologic findings of pathologically proven renal oncocytoma were analyzed in 9 patients. CT was performed in all patients, ultrasonography in 4 patients and MRI in 3 patients. (51) RESULTS: On ultrasonography, the echogenicity of the mass was slightly more hyperechoic than normal renal parenchyma in all 4 cases. Two cases were homogeneous and the remaining two cases were relatively homogeneous. On CT, all 8 cases showed iso-density to slightly low density compared to normal renal parenchyma and 5 cases were homogeneous but the central portion of the mass was of a slightly lower density than the peripheral portion in 3 cases. All six cases had an arterial phase scan and were heterogeneously enhanced. An irregular, lower-enhancing portion was found in the central portion of the mass. Segmental inversion of contrast enhancement was found in 5 of 6 cases that had a dynamic enhancement study. On MR T1-weighted imaging, the mass was of iso-signal intensity to normal renal parenchyma and the central portion of the mass had a slightly hypo-signal intensity than the peripheral portion. On T2-weighted imaging, 2 cases were heterogeneous; the peripheral portion was of low signal intensity and the central portion was of higher signal intensity than normal renal parenchyma. One case was relatively homogeneous and showed a slightly lower signal intensity than that of normal renal parenchyma, except for a central small portion showing high signal intensity. For 2 cases that had a dynamic study, a segmental inversion of contrast enhancement was noted. CONCLUSION: Renal oncocytoma is seen as a well-marginated solid mass lesion. On enhanced scans it is heterogeneously enhanced and segmental inversion of contrast enhancement may be seen. The possibility of oncocytoma can be suggested in cases showing these radiologic findings.
Adenoma, Oxyphilic ; Humans ; Kidney Neoplasms

An adrenocortical oncocytoma is very rare and unusual disease. Only 22 and 2 cases have been reported in the foreign and Korean literatures, respectively. Herein, the case of a left adrenocortical oncocytoma, observed by ultrasonography during a periodic medical examination of a 32 year old male patient is reported.
Adenoma ; Adenoma, Oxyphilic* ; Adult ; Humans ; Male ; Ultrasonography

Adrenocortical oncocytomas are exceptionally rare and most are benign and nonfunctioning. Only 3 cases of adrenal oncocytomas have been reported in the Korean literature and all of them were nonfunctioning. Herein, we report a case of a functioning adrenocortical oncocytoma in a 49-year-old man who presented with Cushing syndrome.
Adenoma, Oxyphilic ; Cushing Syndrome ; Humans ; Middle Aged

OBJECTIVETo investigate the morphologic features and diagnostic criteria of various types pf renal adenomas of the kidney.

METHODSIn addition to light microscopy, electron microscopy, histochemical and immunohistochemical assays were applied. All 19 cases of adenomas were followed up.

RESULTSThree (3) cases of papillary adenoma were featured as papillary or tubulopapillary growth in patterns consisting of tumor cells with basophilic or acidophilic cytoplasm and were positive for both epithelial membrane antigen (EMA) and cytokeratin (CK7). Thirteen (13) cases of oncocytoma were characterized by the diversity of the structures including to be nest, tubular and papillary in pattern; a mixture of cell types including the classic oncocytes, oncoblasts and clear cells which were negative for vimentin and CK7 but positive for EMA. Enormous large mitochondria were obtained in 4 cases of oncocytoma by electronic microscopy. Three (3) cases of metanephric adenoma consisted of closely packed, round tubules lined by small bland cells with solid, glomeruloid constructure. Branching, elongated tubules and polypoid fronds were also detected. Tumor cells were negative for EMA, negative or only focally positive for CK7. Eighteen (18) patients were alive except one oncocytoma patient died 5 years after the diagnosis convinced. All the cases reported in this article had been followed up of 3 - 5 years.

CONCLUSIONSThere are 3 kinds of renal adenomas, namely, the papillary adenoma, oncocytoma, and metanephric adenoma and each kind has its own clincopathological features. The latter two can be recognized by their distinctive morphology, and the former can only be diagnosed according to the size of the tumor as the reference. Histochemical and immohistochemical assays are helpful in differential diagnosis.

Renal oncocytoma has been recently defined histopathologically but many controversies have arised about its origin and differential diagnosis. Until the present time nearly all renal oncocytoma were considered to be benign nature, but rare cases have been reported to be metastasized. We reported a case of renal oncocytoma and synchronous contralateral renal cell carcinoma treated by radical nephrectomy on one side and enucleation on the other side.
Adenoma, Oxyphilic* ; Carcinoma, Renal Cell* ; Diagnosis, Differential ; Nephrectomy

Renal oncocytoma has been recently defined histopathologically but many controversies have arised about its origin and differential diagnosis. Until the present time nearly all renal oncocytoma were considered to be benign nature, but rare cases have been reported to be metastasized. We reported a case of renal oncocytoma and synchronous contralateral renal cell carcinoma treated by radical nephrectomy on one side and enucleation on the other side.
Adenoma, Oxyphilic* ; Carcinoma, Renal Cell* ; Diagnosis, Differential ; Nephrectomy

PURPOSE: Recently, incidental small renal tumors detected by computerized tomography(CT) or ultrasonography(US) have been increasing. Differentiation between the small renal cell carcinoma and benign tumorous lesions is often difficult. To reduce the unnecessary surgical interventions for these small renal tumors, we anayzed the radiologic findings of surgically removed small renal tumors(less than 3cm in diameter) and evaluated whether radiologic studies would predict their histologic findings. MATERIALS AND METHODS: Radiologic findings of 28 renal cell carcinomas(RCC), 7 angiomyolipomas(AML), 4 cysts including 2 multilocular cysts and 1 oncocytoma were analyzed, retrospectively. Density, contour, and heterogenity of the tumors on CT were evaluated, while echogenecity, posttumoral enhancement, peritumoral hypoechoic rim, and intratumoral cystic change on US were evaluated. RESULTS: Tiny fat density on CT was found in 4 of 7 AMLs and 1 of 28 RCCs. On US, 3 of 6 AMLs and 1 of 24 RCCs showed marked hyperechogenecity identical to the renal sinus fat. AMLs showed fat density in 4 of 7(57.1%) on CT and marked hyperechogenecity in 5 of 7(71.4%) on US, respectively. Two AMLs which showed hypoechogenecity and no fat density had less than 5% of fat on histologic examination while others had more than 30% of fat. All AMLs, oncocytoma and most RCCs(73%) showed exophytically out-bulging growth pattern while all benign cysts showed endophytic growth. Posttumoral sonic enhancement was found in 3 of 4 cysts and 1 of 24 RCCs. Peritumoral hypoechoic rim and intratumoral cystic changes were identified in 8 of 24(33%) and 7 of 24(29%) RCCs, respectively, while no such findings were detected in other tumors and cysts. CONCLUSIONS: Fat density on CT or marked hyperechogenecity identical to renal sinus fat on US strongly suggest angiomyolipoma, whereas endophytic growth pattern and posttumoral enhancement on US favor benign cyst. In the meantime, absence of above findings combined with peritumoral halo and/or intratumoral cystic change indicate renal cell carcinoma which should be explored.
Adenoma, Oxyphilic ; Angiomyolipoma ; Carcinoma, Renal Cell ; Retrospective Studies* ; Ultrasonography

PURPOSE: Recently, incidental small renal tumors detected by computerized tomography(CT) or ultrasonography(US) have been increasing. Differentiation between the small renal cell carcinoma and benign tumorous lesions is often difficult. To reduce the unnecessary surgical interventions for these small renal tumors, we anayzed the radiologic findings of surgically removed small renal tumors(less than 3cm in diameter) and evaluated whether radiologic studies would predict their histologic findings. MATERIALS AND METHODS: Radiologic findings of 28 renal cell carcinomas(RCC), 7 angiomyolipomas(AML), 4 cysts including 2 multilocular cysts and 1 oncocytoma were analyzed, retrospectively. Density, contour, and heterogenity of the tumors on CT were evaluated, while echogenecity, posttumoral enhancement, peritumoral hypoechoic rim, and intratumoral cystic change on US were evaluated. RESULTS: Tiny fat density on CT was found in 4 of 7 AMLs and 1 of 28 RCCs. On US, 3 of 6 AMLs and 1 of 24 RCCs showed marked hyperechogenecity identical to the renal sinus fat. AMLs showed fat density in 4 of 7(57.1%) on CT and marked hyperechogenecity in 5 of 7(71.4%) on US, respectively. Two AMLs which showed hypoechogenecity and no fat density had less than 5% of fat on histologic examination while others had more than 30% of fat. All AMLs, oncocytoma and most RCCs(73%) showed exophytically out-bulging growth pattern while all benign cysts showed endophytic growth. Posttumoral sonic enhancement was found in 3 of 4 cysts and 1 of 24 RCCs. Peritumoral hypoechoic rim and intratumoral cystic changes were identified in 8 of 24(33%) and 7 of 24(29%) RCCs, respectively, while no such findings were detected in other tumors and cysts. CONCLUSIONS: Fat density on CT or marked hyperechogenecity identical to renal sinus fat on US strongly suggest angiomyolipoma, whereas endophytic growth pattern and posttumoral enhancement on US favor benign cyst. In the meantime, absence of above findings combined with peritumoral halo and/or intratumoral cystic change indicate renal cell carcinoma which should be explored.
Adenoma, Oxyphilic ; Angiomyolipoma ; Carcinoma, Renal Cell ; Retrospective Studies* ; Ultrasonography