IgG4-related disease (IgG4-RD) is an immunomodulated inflammatory disease that usually affects the pancreas and parotid glands. Although lung involvement is rare, it has been recently reported and could mimic various other diagnoses. We present a case of IgG4-RD whose symptoms and images raised the suspicion of a malignant lymphoproliferative lung neoplasm. It is imperative to differentiate both diseases, since their treatment and prognosis vary.

Los cánceres de vía urinaria baja pueden surgir de la vejiga, el uraco o la uretra, siendo el carcinoma urotelial el tipo histológico predominante. La presentación clínica suele ser insidiosa y estar relacionada con la presencia de hematuria. El diagnóstico y la estadificación de estos cánceres requieren imágenes radiológicas, como tomografía computarizada o resonancia magnética. Este artículo revisa la naturaleza específica de los cánceres de vía urinaria baja y su manifestación imagenológica.

Mixed epithelial-stromal tumors of kidney are rare neoplasm usually described in postmenopausal females under estrogenic therapy. Although tumor behavior is in general benign, sporadic cases with an aggressive behavior have been described. The present case is a 41-year-old male with lumbar pain, hematuria and lump in left kidney. Tumor spread assessment evidenced no findings and therefore radical nephrectomy was performed. Grossly tumor was peripherally located, whitish, round-shaped, measuring 9 cm. It showed spread to the pyelocalyceal system and necrotic areas. Histologically consisted of biphasic neoplasm, with epithelial component of branching ducts that covered a moderately cellular and partly spindle-cell stroma, with focal areas of marked atypia and prominent mitotic activity. Immunostains were positive for Pancytokeratin and Keratin 7 in the epithelial component, positive for Vimentin in both epithelial and stromal components, and positive for Actin only in isolated stromal cells. Immunostains were negative for Estrogen and Progesterone Receptors and CD99. Ki-67 was positive in 60% of pleomorphic stromal areas, in 20% of low-grade stromal areas and in < 5% of the epithelial component. Disease progressed in a few months with bilateral lung metastases and death. The present case is reported by to be a very rare case with malignant behavior and fatal outcome in a male patient. The aim of the present work is to contribute to the knowledge and characterization of such lesions.

Lower urinary tract cancers can arise from the bladder, urachus, or urethra, with urothelial carcinoma being the predominant histological type. The clinical presentation is usually insidious and related to the presence of hematuria. Diagnosis and staging of these cancers require radiological imaging, such as computed tomography or magnetic resonance imaging. This article reviews the specific nature of lower urinary tract cancers and their imaging manifestation.