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A rare cause for a common symptom

M. Vishnu Sharma, B. Srinivas Kakkilaya, Irfan A. Shekh, Alka C. Bhat, D.S. Harsha
Breathe 2016 12: e64-e74; DOI: 10.1183/20734735.006716
M. Vishnu Sharma
1Dept of Respiratory Medicine, A.J. Institute of Medical Sciences, Mangalore, India
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  • For correspondence: drvishnusharmag@gmail.com
B. Srinivas Kakkilaya
2Light House Polyclinic, Mangalore, India
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Irfan A. Shekh
1Dept of Respiratory Medicine, A.J. Institute of Medical Sciences, Mangalore, India
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Alka C. Bhat
1Dept of Respiratory Medicine, A.J. Institute of Medical Sciences, Mangalore, India
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D.S. Harsha
1Dept of Respiratory Medicine, A.J. Institute of Medical Sciences, Mangalore, India
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    Figure 1

    Normal chest radiograph.

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    Figure 2

    Ultrasound of the abdomen. a) Oblique axial image of the left kidney, showing an ill-defined heterogeneous hypoechogenic mass lesion, possibly arising from the upper and interpolar regions of the left kidney. b) Long-axis sagittal view of the left kidney, confirming the mass is located in the upper pole.

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    Figure 3

    CECT of the abdomen, showing a) coronal view, arterial phase, and b) axial view at the upper lumbar level, T12 to L1 vertebral level.

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    Figure 4

    CT of the thorax, showing a) lungs at T3 vertebral level, b) lungs at T7 vertebral level, and c) post-contrast mediastinal view at T7 vertebral level.

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    Figure 5

    Gross specimen, showing a) the outer surface of the nephrectomy specimen with intact perinephric fat, and b) the cut surface of the left kidney, which shows an ill-defined tumour mass with a variegated appearance situated in the upper pole.

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    Figure 6

    Haematoxylin and eosin stain at a) 100× and b) 400× magnification. Tumour cells are arranged in sheets and lobular pattern, with malignant clear cells diagnostic of RCC.

Tables

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  • Table 1

    Investigation results

    ParameterResult
    Haemoglobin g·dL-113.2
    Total leukocyte count cells·mm-36400
    Differential leukocyte count %
    Neutrophils59
    Lymphocytes39
    Eosinophils2
    Monocytes0
    ESR mm·h-1112
    Liver and renal function testsNormal
    FBS mg·dL-1159
    PPBS mg·dL-1200
    Urine routine examinationNo abnormality detected
    Haemoglobin A1c %7.3
    Peripheral smear examination for malaria parasiteNegative
    Serology (HIV, HCV, HBsAg)Negative
    • ESR: erythrocyte sedimentation rate; FBS: fasting blood sugar; PPBS: post-prandial blood sugar; HCV: hepatitis C virus; HBsAg: hepatitis B surface antigen.

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Vol 12 Issue 3 Table of Contents
Breathe: 12 (3)
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A rare cause for a common symptom
M. Vishnu Sharma, B. Srinivas Kakkilaya, Irfan A. Shekh, Alka C. Bhat, D.S. Harsha
Breathe Sep 2016, 12 (3) e64-e74; DOI: 10.1183/20734735.006716

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A rare cause for a common symptom
M. Vishnu Sharma, B. Srinivas Kakkilaya, Irfan A. Shekh, Alka C. Bhat, D.S. Harsha
Breathe Sep 2016, 12 (3) e64-e74; DOI: 10.1183/20734735.006716
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