Introduction and importance: Nephrolithiasis, a common urological disease, could indicate a more ominous pathology beyond the kidneys. Patients who present with renal stones must be investigated for serum calcium and subsequently parathyroid hormones, if indicated, as one of the clinical presentations of primary hyperparathyroidism is renal stones. Case presentation: A 48-year-old married female with a past medical history significant for renal stones presented to the clinic chiefly complaining of muscle pain, joint pain, and fatigue. After thorough investigations, she was diagnosed with a case of primary hyperparathyroidism due to parathyroid adenoma and was managed surgically according to guidelines. Clinical discussion: Hypercalcemia, serum calcium of greater than 2 standard deviations above the reference value, is commonly seen to be associated with parathyroid mass therefore, assessment of serum calcium is a necessary step toward the diagnosis of parathyroid adenoma in cases with recurrent renal stones. Conclusion: Recurrent nephrolithiasis requires more thorough investigation for the possible underlying cause. Primary hyperparathyroidism due to parathyroid adenoma can present with recurrent renal stones and some vague symptoms.
Background: The current study was undertaken to determine the validity of thyroid fine needle aspiration cytology (FNAC) in Duhok-Iraq to clarify its traded diagnostic errors locally and broadly. Patients and Methods: All thyroid cytologic and histologic cases referred to Duhok Pathology Centers, between January 2013 and December 2016, were enrolled in this study. Cytologic findings were compared with their corresponding final histologic results. The validity parameters of cytology were assessed and cases showing cytologic and histologic non-conformance were re-evaluated to highlight the dependant cytologic pitfalls used locally and in the literature. Results: Of 553 thyroid biopsies with 81.6% benign and 18.4% malignant, only 125 cases had preoperative diagnostic cytology and subsequent histologic final diagnoses. Of these, apart from 2 unsatisfactory cases, only 6 (4.9%) cytologic reports were proved not to be matched with their corresponding histologic results. The remaining 117 (95.1%) cases showed complete agreement between the two evaluation tests. Malignancy was predicted by cytology in 82.9%with a sensitivity of 94.3% and specificity of 95.5%. All the 6 unmatched cases were aspirated blindly with no image guide, 4 were false positive resulting in 3.2%false positive rate and 89.2% positive predictive value. The remaining unmatched 2 cases were false negative cytologies that gave 1.6% false negative rate and 97.7% negative predictive value. Cytologically, 5 (83.3%) unmatched smears, 4 false positive and 1 false negative, appeared in smears of lymphocyte-rich thyroid lesions, particularly Hashimoto's. The false positive pitfalls comprised 2 over diagnosis of hypercellular smears showing some features of papillary carcinoma, 1 overestimation of the large cells with nuclear atypia as follicular carcinoma and 1 over diagnosis of lymphoid hyperplasia as lymphoma. On the other hand, low cellular smears with unclear atypical lymphoid cells underdiagnosed low grade MALT lymphoma and unobvious cytologic criteria missed the diagnosis of papillary carcinoma. Conclusions: Lymphocyte-rich thyroid smears should be interpreted by experienced cytopathologists in the context of clinical, radiological and cytologic findings as suchcases may give certain cytomorphologic pitfalls that may decrease the cytologic validity. In suspicious cases, further tests should be justified to overcome the limitations and pitfalls of features when applied alone.
Background: percutaneous nephrolithotomy (PCNL) is regarded as the treatment of choice for most renal stones larger than 2cm. Colon injury is one of the rare and preventable complications during PCNL. The rare and unusual location of the colon behind the kidney (retrorenal colon) is an anatomical predisposing factor and other factors that can result in colon perforation during PCNL. Aim: To evaluate the prevalence of retrorenal and posterolateral colon and among CT scanned patients.Patients and methods: one thousand CT scanned patients of all ages and both sexes were included and their CT images were evaluated prospectively at the CT scan center at Azadi Teaching Hospital for the presence of retrorenal colon and the relation of the colon to different parts of the kidney. Results: In this study, 1000 CT scanned patients of different ages and both sexes were included. There were 522 males and 478 females; their ages ranged from 6 to 85 years. The overall prevalence of retrorenal colon was 7.5% (6.3% in males and 8.7% in females). The prevalence of retro renal colon according to different ages was: at below 10 y was 16%, 11-20 years 8.3%, 21-30 y 5.9 %, 31-40 y 7.2 %, 41-50y 7.2%, 51-60y 11.2%, 61-70y 5.8% 71-80y 7.2% and at 81-90 y was 9%, and the differences regarding the ages and sexes were statistically not significant. The lower pole of the left kidney is the most common part involved by the retrorenal colon in 70.6%, while the right lowers pole by 12%, the left middle part by 10.6%, and bilateral lower poles by 6.6%. Conclusion: Locally, the prevalence of retrorenal colon is within the usual range with no sex or age predominance, and a pre-operative abdominal CT scan (native one) is a diagnostic one and is essential if left lower renal calyx is planned to be targeted to avoid colonic injury.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.