Humans ; Polycystic Kidney, Autosomal Recessive/genetics*

Endometrial papillary serous carcinoma (EPSC) is a distinct variant of endometrial adenocarcinoma that histologically resembles ovarian serous papillary adenocarcinoma and has an aggressive clinical course. Usually, the tumor is diagnosed at the advanced stage. The tumor has well confused with metastatic ovarian tumor of identical histology. Dignosis of EPSC should be considered when the cervico-vaginal smear reveals numerous papillary clusters of tumor cells with macronucleoli and psammoma bodies. Recently, we have experienced two cases of EPSC diagnosed on cervico-vaginal smears, which revealed characteristic cytologic features including numerous papillary clusters of tumor cells with macronucleoli. The cytologic diagnoses were confirmed on histologic sections.
Adenocarcinoma ; Adenocarcinoma, Papillary ; Diagnosis ; Polycystic Kidney, Autosomal Recessive*

Autosomal recessive polycystic kidney disease (ARPKD) is a severe form of polycystic kidney disease that is characterized by enlarged kidneys and congenital hepatic fibrosis. The clinical spectrum of this condition shows wide variation. Approximately 30-50% of affected individuals die in the neonatal period, while others survive into adulthood. ARPKD is caused by mutations in the polycystic kidney and hepatic disease 1 (PKHD1) gene on chromosome 6p12, which consists of 86 exons variably assembled into many alternatively spliced transcripts. We report a case of a pathogenic PKHD1 frameshift mutation, c.889_931del43, which was identified using direct full sequencing, associated with enlarged cystic kidneys and dilatation of intrahepatic bile duct, as observed on imaging studies.
Bile Ducts, Intrahepatic ; Dilatation ; Exons ; Fibrosis ; Frameshift Mutation ; Kidney ; Kidney Diseases, Cystic ; Polycystic Kidney Diseases ; Polycystic Kidney, Autosomal Recessive*

OBJECTIVE: To explore the genetic etiology of a fetus with autosomal recessive polycystic kidney disease (ARPKD). METHODS: Prenatal ultrasonography has revealed oligohydramnios and abnormal structure of fetal kidneys. After careful counseling, the couple opted induced abortion. With informed consent, genomic DNA was extracted from the muscle sample of the abortus and peripheral blood samples of the couple. High throughput whole exome sequencing was carried out to detect potential variants in relation with the disease. Suspected variants were verified by Sanger sequencing. RESULTS: Prenatal ultrasound revealed increased size of fetal kidneys, with multiple hyperechos from the right kidney, and multiple hyperechos with anechoic masses within the left kidney. DNA sequencing revealed that the fetus has carried heterozygous variants of the PKHD1 gene, including c.7994T>C inherited from its father, and two heterozygous variants of the PKHD1 gene c.5681G>A from its mother. CONCLUSION The compound heterozygous c.7994T>C and c.5681G>A variants of the PKHD1 gene probably underlay the pathogenesis of ARPKD in this fetus. Above results can provide guidance for subsequent pregnancies of the couple.
Female ; Fetus ; Genetic Testing ; Humans ; Mutation ; Polycystic Kidney, Autosomal Recessive/genetics* ; Pregnancy ; Receptors, Cell Surface/genetics*

Multicystic dysplastic kidney (MCDK) is an incidental finding on prenatal ultrasound examination and this abnormality may be unilateral or bilateral. In approximately 20-50 % of case, there are also abnormalities of the contralateral kidney which should also be evaluated. These abnormalities are mostly bilateral MCDK, vesicoureteral reflux, ureteropelvic junction obstruction or renal agenesis. Unilateral MCDK and contralateral polycystic kidney are very rare congenital anomalies. We experienced 33-year-old multigravida with left MCDK and severe oligohydramnios at 18 weeks gestation. The evaluation of right kidney is difficult due to severe oligohydramnios. After amnioinfusion, the fetus showed enlarged and hyperechoic right kidney. We report a case of unilateral MCDK and contralateral polycystic kidney diagnosed by ultrasonography after amnioinfusion and confirmed by autopsy.
Adult ; Congenital Abnormalities ; Female ; Fetus ; Humans ; Incidental Findings ; Kidney ; Kidney Diseases ; Multicystic Dysplastic Kidney ; Oligohydramnios ; Polycystic Kidney Diseases ; Polycystic Kidney, Autosomal Recessive ; Pregnancy ; Vesico-Ureteral Reflux

An 11 year-old girl, whose condition was diagnosed as juvenile-type autosomal recessive polycystic kidney disease (ARPKD) at five years of age, presented with chest pain and dyspnea that had developed suddenly two months previously. Two-dimensional echocardiography, Doppler study and cardiac catheterization confirmed pulmonary hypertension. The underlying mechanism of the diagnosis was not defined. Two and a half months after the onset of symptoms, the patient died of pulmonary hypertensive crisis. Careful regular checks of cardiopulmonary status using two-dimensional echocardiography and Doppler should be considered for the early detection of pulmonary hypertension even in an asymptomatic patient with juvenile-type ARPKD.
Biopsy ; Case Report ; Child ; Echocardiography, Doppler ; Fatal Outcome ; Female ; Human ; Hypertension, Pulmonary/ultrasonography ; Hypertension, Pulmonary/complications* ; Liver Cirrhosis/pathology ; Liver Cirrhosis/complications ; Polycystic Kidney, Autosomal Recessive/ultrasonography ; Polycystic Kidney, Autosomal Recessive/complications*

BACKGROUNDAutosomal recessive polycystic kidney disease (ARPKD) is a rare inherited disease, which is a disorder with multiple organ involvement, mainly the kidney and liver. It is caused by mutations in the PKHD1 gene. Here, we reported the clinical characteristics of a case with ARPKD and analyze the genetic features of this patient as well as of his father using targeted exome sequencing and Sanger sequencing.

METHODSGenomic DNA was extracted from peripheral blood leukocytes obtained from a patient with ARPKD. The mutations were identified using exome sequencing and confirmed by Sanger sequencing.

RESULTSThe patient was diagnosed as ARPKD based on ultrasonography and abdominal computed tomography which showed polycystic changes, multiple calcinosis of both kidneys, and multiple dilated bile ducts of the liver. Compound heterozygous PKHD1 gene mutations A979G and G5935A, which lead to substitution of an asparagine for an aspartate at amino acid 327 (N327D) and a glycine for an arginine at amino acid 1979 (G1979R) respectively, were identified using targeted exome sequencing and confirmed by Sanger sequencing for the patient. In addition, the father of the patient was identified to be a carrier of heterozygous A979G mutation of this gene.

CONCLUSIONSWe identified that the compound heterozygous PKHD1 gene mutations are the molecular basis of the patient with ARPKD. Targeted exome sequencing is suitable for genetic diagnosis of single-gene inherited diseases like ARPKD in which the pathogenic gene is a large.

Adolescent ; Exome ; genetics ; Genetic Predisposition to Disease ; Humans ; Male ; Mutation ; Polycystic Kidney, Autosomal Recessive ; genetics ; Receptors, Cell Surface ; genetics

OBJECTIVE: To explore the clinical characteristics and molecular pathogenesis of a child with autosomal dominant polycystic kidney disease (ARPKD). METHODS: Prenatal ultrasound, clinical feature and family history of the child were analyzed. Whole exome sequencing was carried out for the child. Candidate variants were verified by Sanger sequencing. RESULTS: The child has featured premature birth with very low weight, neonatal respiratory distress, metabolic acidosis, and congenital nephrotic syndrome. Gene sequencing revealed that he has harbored compound heterozygous variants of the PKHD1 gene (NM_138694), including c.3885T>A (p.Tyr1295*) in exon 32 and c.7812_7816dupTGATA (p.Thr2606Metfs*63) in exon 49, which were respectively inherited from his mother and father. CONCLUSION The compound heterozygous variants of the PKHD1 gene probably underlay the disease in this child.
Child ; Exons ; Female ; Genetic Testing ; Humans ; Infant, Newborn ; Male ; Mutation ; Polycystic Kidney, Autosomal Recessive/genetics* ; Pregnancy ; Receptors, Cell Surface/genetics*

OBJECTIVE: To explore the genetic basis for a fetus with renal abnormalities through whole exome sequencing and imaging examination. METHODS: Clinical data and result of medical imaging of the fetus was collected. Amniotic fluid sample was collected for the extraction of fetal DNA. Whole exome sequencing was carried out. Candidate variants were verified by Sanger sequencing. RESULTS: Prenatal ultrasonography showed that the fetus had bilateral enlargement of the kidneys with hyperechogenicity and diffuse renal cysts. Whole exome sequencing revealed that the fetus carried compound heterozygous variants of the PKHD1 gene, namely c.5137G>T and c.2335_2336delCA, which were derived from its mother and father, respectively. CONCLUSION The fetus was diagnosed with autosomal recessive polycystic kidney disease through combined prenatal ultrasonography and whole exome sequencing. The compound heterozygous variants of the PKHD1 gene probably underlay the pathogenesis in the fetus. The results have enabled prenatal diagnosis and genetic counseling for its parents.
Female ; Genetic Testing ; Humans ; Polycystic Kidney, Autosomal Recessive/genetics* ; Pregnancy ; Prenatal Diagnosis ; Receptors, Cell Surface/genetics* ; Whole Exome Sequencing

Autosomal recessive polycystic kidney disease is among the most common inherited ciliopathies and is caused by mutations in the polycystic kidney and hepatic disease 1 (PKHD1) gene. Despite its great phenotypic variability, this condition is usually diagnosed during the neonatal and early infantile periods. We report a 37+3 -gestational-week neonate presenting with fatal autosomal recessive polycystic kidney disease who died at 28 hours of life from severe respiratory failure. The familial history is significant because a previous sibling died in utero at 24+2 weeks of gestational age and was diagnosed with polycystic kidney disease based on prenatal ultrasonography and autopsy. Our patient's autopsy revealed findings compatible with polycystic kidney disease. In addition, a PKHD1 gene study of peripheral blood leukocytes identified the compound heterozygote mutation c.274C>T(p.Arg92Trp), as well as the novel heterozygous nonsense mutation c.2770C>T(p.Gln924*).
Autopsy ; Codon, Nonsense ; Gestational Age ; Heterozygote ; Humans ; Infant, Newborn* ; Leukocytes ; Polycystic Kidney Diseases ; Polycystic Kidney, Autosomal Recessive* ; Respiratory Insufficiency ; Siblings ; Ultrasonography, Prenatal