Eble JN, Sauter G., Epstein JI, Sesterhenn IA - iarc

Leukaemia
A. Orazi
Interstitial infiltration of leukaemic cells
without a nodular mass is best referred to
as extramedullary leukaemia in kidney.
Diffuse infiltration of the kidney secondary
to acute myeloid and lymphoblastic
leukaemias, megakaryoblastic leukaemia,
or chronic lymphocytic leukaemia
has rarely been reported in the literature
{989}. Myeloid sarcoma (MS) is a neoplastic
proliferation of myeloblasts or
immature myeloid cells forming a mass in
an extramedullary site. MS may occur
"de novo" or simultaneously with acute
myeloid leukemia, myeloproliferative disorder,
or myelodysplastic syndrome
{154,989}. It may represent the first manifestation
of leukaemia relapse in a previously
treated patient. The commonest
type of myeloid sarcoma occurring in the
kidney is known as granulocytic sarcoma,
a tumour composed of myeloblasts
and promyelocytes {154}.
Fig. 1.131 Myeloid sarcoma in the kidney showing
multiple haemorrhagic fleshy nodules.
Fig. 1.132 Myeloid sarcoma in the kidney. The malignant proliferation consists of a mixture of promyelocytes
and myeloblasts.
Germ cell tumours
I.A. Sesterhenn
Primary renal choriocarcinomas have
rarely been reported and are difficult to
distinguish from high grade urothelial
carcinomas with syncytiotrophoblasts.
Most of the cases in the literature {1019,
1135} are metastases from testicular
germ cell tumours {1168,1728,1804}.
The wide range of differentiation in
nephroblastoma can resemble teratoma.
Reports of teratomas of the kidney are
very rare. Reported cases have involved
the renal parenchyma or the renal hilus
and have been indistinguishable from
teratomas of the gonads. {6,138,580,
916,1986,2878}.
Plasmacytoma / Leukaemia / Germ cell tumours
87