Author/Authors :
Mahmoudieh, Leila Shahid Beheshti University of Medical Sciences - Department of Internal Medicine , Saeedinia, Arezoo Shahid Beheshti University of Medical Sciences - Department of Endocrinology , Ahmadpoor, Pedram Shahid Beheshti University of Medical Sciences - Department of Nephrology , Temannaie, Zeinab Shahid Beheshti University of Medical Sciences - Department of Internal Medicine , Parvin, Mahmoud Shahid Beheshti University of Medical Sciences - Department of Pathology , Torbati, Peyman Shahid Beheshti University of Medical Sciences - Department of Pathology , Mirdamadi, Mohammad Hossein Shahid Beheshti University of Medical Sciences - Department of Pathology , Nafar, Mohsen Shahid Beheshti University of Medical Sciences - Department of Nephrology
Abstract :
A 32-year-old woman was admitted because of severe uncontrolled
hypertension associated with intermittent headache, diaphoresis,
and blurred vision. She had a 3-year history of hypertension. Her
symptoms were worsened by urination. Physical examination
revealed a blood pressure of 155/120 mm Hg and bilateral
papilledema. The tilt test was negative. Bruit over the renal artery
was not audible. Laboratory examinations are shown in the Table.
Abdominopelvic computed tomography showed lymphadenopathy
in the celiac region and a 23-mm enhancing lesion in the
bladder floor. No mass lesions were seen in the adrenal glands.
Abdominopelvic magnetic resonance imaging confirmed computed
tomography findings (Figure 1). Metaiodobenzylguanidine scan
was negative. A 2.5 × 2.5 × 1-cm mass was completely removed
laparoscopically. Pathologic report concluded urothelial mucosa
with submucosal neoplasm composed of monomorphic polygonal
cells with central round nuclei. Fine speckled chromatin and marked
nucleoli as well as granular eosinophilic cytoplasm arranged as
nest formation. No obvious mitotic figures were seen. Diagnosis of
paraganglioma was confirmed with chromogranin and synaptophysin
immunohistochemical staining (Figure 2).
