Living Kidney Donation From a Donor With Pulmonary Sarcoidosis: A Case Report and Review of the Literature.

BACKGROUND: Sarcoidosis is a chronic systemic disease that is characterized by the formation of noncaseating granuloma and whose etiology is unclear. It is unclear whether patients with sarcoidosis are suitable organ donors. CASE: We treated a 56-year-old woman with pulmonary sarcoidosis who donated her kidney. She was previously in good health and was diagnosed with pulmonary sarcoidosis during her preoperative examination. Because she presented with no symptoms and was otherwise in good condition, donor nephrectomy was performed. RESULTS: Baseline biopsy examination showed no evidence of sarcoidosis. One year after transplantation, both the donor and the recipient had not developed kidney dysfunction or recurrence of sarcoidosis. CONCLUSION: This is a rare case in which a patient with pulmonary sarcoidosis donated a kidney for transplantation, and both the recipient and the donor were clinically healthy. A patient with sarcoidosis and no kidney lesion can donate a living kidney, because transplantation appears to be safe for both the recipient and the donor.

Two cases of metastatic bladder cancers showing diffuse thickening of the bladder wall.

Metastatic bladder cancer showing diffuse thickening of the bladder wall is very rare. We report two cases of metastatic bladder cancer arising from a stomach cancer and acute lymphocytic leukemia. Hydronephrosis and diffuse thickening of the bladder wall were revealed by ultrasonography and computed tomography. Transurethral biopsy and percutaneous whole wall needle biopsy of the bladder were useful for diagnosis. The possibility of metastasis or recurrence of prior and other malignancies should therefore be considered when the clinical features described here are encountered.

Clinicopathological characteristics of skipping lymph node metastases in patients with colorectal cancer.

BACKGROUND: We have sometimes experienced cases of colorectal cancer with skipping lymph node metastasis in which distant nodes were positive but those closer to the tumor were negative. There have been few reports of this condition and its clinical characteristics have not been clarified. This study was conducted to clarify the status of skipping lymph node metastasis and its clinicopathological characteristics in colorectal cancer. METHODS: We analyzed 452 patients with colorectal cancer and nodal metastases (270 with colon cancer and 182 with rectal cancer). All the resected nodes were examined using histological procedures with a microscope and were classified by their location according to the General Rules for Clinical and Pathological Studies on Cancer of the Colon, Rectum and Anus. We studied the status of skipping nodal status and the correlation between the nodal status and clinicopathological findings, including the disease-free survival, depth of tumor, histological type, staging and recurrence. RESULTS: Twenty-eight (10.4%) of the colon cancer patients and 20 (11.0%) of the rectal cancer patients were found to have skipping nodal metastases. In rectal cancer patients with n2 (nodal metastases at the N2 site) in the direction of the main node, patients with skipping lymph node metastases had a significantly better prognosis than those without (p = 0.026). In all colon cancer patients and rectal cancer patients with lateral n3 (nodal metastases at the lateral N3 site), there were a tendency for those with skipping nodal metastases to have better disease-free survival rates (p = 0.1). Also, the mean number of positive nodes in skipping cases was significantly lower than that in non-skipping cases. In addition, skipping nodal metastases in rectal cancer suggested a possibility of bypass flow which was not generally recognized. CONCLUSION: These findings in colorectal cancer suggest the presence of previously unknown lymphatic tracts and that the cancers concerned have a better prognosis than those without skipping nodal metastases.