Autopsy and Case Reports
https://autopsyandcasereports.org/article/doi/10.4322/acr.2021.406
Autopsy and Case Reports
Clinical Case Report

Juxtaglomerular cell tumor: report of a case with unusual presentation

Priscilla Quach; Ameer Hamza

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Abstract

Juxtaglomerular cell tumor is a benign, renin-secreting neoplasm. The tumor arises from the juxtaglomerular apparatus cells of the kidney. Because the tumor is hormonally active, patients usually suffer from hypokalemia, hyperaldosteronism, and hypertension. Herein, we describe a case of a 19-year-old Asian female with a somewhat unusual presentation.

A 19-year-old Asian female presented with upper extremity weakness, numbness, and tingling. On physical examination, the only notable finding was hypertension. Extensive workup revealed elevated aldosterone level and plasma renin activity. CT scan of the abdomen revealed a 2.2 cm mass in the lower pole of the left kidney. The mass was resected by partial nephrectomy. On microscopic evaluation, the tumor had glomoid appearance with sheets of uniform, round to polygonal cells with clear to eosinophilic cytoplasm. Immunohistochemical stains showed the tumor cells to be positive for CD117, CD34 and CD10 and negative for ER, PR, CK7, PAX-8, pan-cytokeratin, EMA, S100, Melan-A, HMB45, SMA and CAIX. Diagnosis of Juxtaglomerular cell tumor was rendered. This case highlights the importance of a regular physical exam and a high index of suspicion in patients presenting with unusual complaints.

Keywords

Glomus tumor, Renin, Aldosterone, Juxtaglomerular apparatus, Hypertension

References

1 Moch H, Humphrey PA, Ulbright TM, Reuter VE. WHO classification of tumours of the urinary system and male genital organs. Lyon: IARC; 2016.

2 Martin SA, Mynderse LA, Lager DJ, Cheville JC. Juxtaglomerular cell tumor: a clinicopathologic study of four cases and review of the literature. Am J Clin Pathol. 2001;116(6):854-63. http://dx.doi.org/10.1309/B10J-FKQ5-J7P8-WKU4. PMid:11764074.

3 Kim HJ, Kim CH, Choi YJ, Ayala AG, Amirikachi M, Ro JY. Juxtaglomerular cell tumor of kidney with CD34 and CD117 immunoreactivity: report of 5 cases. Arch Pathol Lab Med. 2006;130(5):707-11. http://dx.doi.org/10.5858/2006-130-707-JCTOKW. PMid:16683889.

4 Jiang S, Yang Y, Wu R, et al. Characterization and management of juxtaglomerular cell tumor: analysis of 9 cases and literature review. Balkan Med J. 2020;37(5):287-90. http://dx.doi.org/10.4274/balkanmedj.galenos.2020.2019.12.79. PMid:32441904.

5 Shera AH, Baba AA, Bakshi IH, Lone IA. Recurrent malignant juxtaglomerular cell tumor: a rare cause of malignant hypertension in a child. J Indian Assoc Pediatr Surg. 2011;16(4):152-4. http://dx.doi.org/10.4103/0971-9261.86876. PMid:22121315.

6 Shao L, Manalang M, Cooley L. Juxtaglomerular cell tumor in an 8-year-old girl. Pediatr Blood Cancer. 2008;50(2):406-9. http://dx.doi.org/10.1002/pbc.21048. PMid:16972237.

7 Viera AJ, Neutze D. Diagnosis of secondary hypertension: an age-based approach. Am Fam Physician. 2010;82(12):1471-8. PMid:21166367.

8 Tanabe A, Naruse M, Ogawa T, et al. Dynamic computer tomography is useful in the differential diagnosis of juxtaglomerular cell tumor and renal cell carcinoma. Hypertens Res. 2001;24(4):331-6. http://dx.doi.org/10.1291/hypres.24.331. PMid:11510743.

9 Kang S, Guo A, Wang H, et al. Magnetic resonance imaging features of a juxtaglomerular cell tumor. J Clin Imaging Sci. 2015;5:68. http://dx.doi.org/10.4103/2156-7514.172976. PMid:26900492.

10 Têtu B, Vaillancourt L, Camilleri JP, Bruneval P, Bernier L, Tourigny R. Juxtaglomerular cell tumor of the kidney: report of two cases with a papillary pattern. Hum Pathol. 1993;24(11):1168-74. http://dx.doi.org/10.1016/0046-8177(93)90211-X. PMid:8244316.

11 Endoh Y, Motoyama T, Hayami S, Kihara I. Juxtaglomerular cell tumor of the kidney: report of a non-functioning variant. Pathol Int. 1997;47(6):393-6. http://dx.doi.org/10.1111/j.1440-1827.1997.tb04513.x. PMid:9211527.

12 Kodet R, Taylor M, Váchalová H, Pýcha K. Juxtaglomerular cell tumor: an immunohistochemical, electron-microscopic, and in situ hybridization study. Am J Surg Pathol. 1994;18(8):837-42. http://dx.doi.org/10.1097/00000478-199408000-00011. PMid:8037298.

13 López G-Asenjo JA, Blanco González J, Ortega Medina L, Sanz Esponera J. Juxtaglomerular cell tumor of the kidney: morphological, immunohistochemical and ultrastructural studies of a new case. Pathol Res Pract. 1991;187(2-3):354-61, discussion 360-1. http://dx.doi.org/10.1016/S0344-0338(11)80804-6. PMid:2068020.

14 Kuroda N, Maris S, Monzon FA, et al. Juxtaglomerular cell tumor: a morphological, immunohistochemical and genetic study of six cases. Hum Pathol. 2013;44(1):47-54. http://dx.doi.org/10.1016/j.humpath.2012.04.006. PMid:22939575.

15 Al-Ahmadie HA, Yilmaz A, Olgac S, Reuter VE. Glomus tumor of the kidney: a report of 3 cases involving renal parenchyma and review of the literature. Am J Surg Pathol. 2007;31(4):585-91. http://dx.doi.org/10.1097/01.pas.0000213373.64053.41. PMid:17414106.

16 Wang F, Shi C, Cui Y, Li C, Tong A. Juxtaglomerular cell tumor: clinical and immunohistochemical features. J Clin Hypertens (Greenwich). 2017;19(8):807-12. http://dx.doi.org/10.1111/jch.12997. PMid:28317244.

17 Park HK, Zhang S, Wong MK, Kim HL. Clinical presentation of epithelioid angiomyolipoma. Int J Urol. 2007;14(1):21-5. http://dx.doi.org/10.1111/j.1442-2042.2006.01665.x. PMid:17199855.

18 Martignoni G, Bonetti F, Chilosi M, et al. Cathepsin K expression in the spectrum of perivascular epithelioid cell (PEC) lesions of the kidney. Mod Pathol. 2012;25(1):100-11. http://dx.doi.org/10.1038/modpathol.2011.136. PMid:21874011.

19 Duan X, Bruneval P, Hammadeh R, et al. Metastatic juxtaglomerular cell tumor in a 52-year-old man. Am J Surg Pathol. 2004;28(8):1098-102. http://dx.doi.org/10.1097/01.pas.0000126722.29212.a7. PMid:15252319.
 


Submitted date:
08/25/2022

Accepted date:
10/12/2022

Publication date:
10/21/2022

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