Introduction: The aim of this study was to identify relevance of subclinical pathological findings in the kidneys of living donors and correlate these with early graft renal function. Methods: This was a prospective study on 84 living donor kidney transplant recipients over a period of two years. In all the donors, cortical wedge biopsy was taken and sent for assessment of glomerular, mesangial, and tubule status. The graft function of patients with normal histology was compared with those of abnormal histological findings at one, three, and six months, and one year post-surgery. Results: Most abnormal histological findings were of mild degree. Glomerulosclerosis (GS, 25%), interstitial fibrosis (13%), acute tubular necrosis (ATN 5%), and focal tubal atrophy (5%) were the commonly observed pathological findings in zero-hour biopsies. Only those donors who had histological changes of interstitial fibrosis and ATN showed progressive deterioration of renal function at one month, three months, six months, and one year posttransplantation. In donors with other histological changes, no significant effect on graft function was observed. Conclusion: Zero-hour cortical biopsy gave us an idea of the general status of the donor kidney and presence or absence of subclinical pathological lesions. A mild degree of subclinical and pathological findings on zero-hour biopsy did not affect early graft renal function in living donor kidney transplantation. Zero-hour cortical biopsy could also help in discriminating donor-derived lesions from de novo alterations in the kidney that could happen subsequently.

Scrotal leiomyosarcoma is a rare tumor arising from the dartos layer of the scrotum presenting as firm, rubbery, non-tender, irregular mass. To date about 37 cases of leiomyosarcoma of scrotum have so far been reported. Treatment involves wide surgical excision with tumor free margins. We report a case of scrotal leiomyosarcoma in a 48-year-old man which was treated by a wide surgical excision and follow up of 14 months showed no recurrence of tumor.

Ureteropelvic junction obstruction (UPJO) with giant hydronephrosis is relatively rare in adults as compared to children. Most of the UPJO reported or seen in daily practice have a distinct hydronephrosis with a narrow ureteropelvic junction and a collapsed ureter distally. We present images a case of an adult female with Left UPJO, which on MRI mimicked an ‘elephant head’.

Introduction:Published studies about contrast-induced nephropathy (CIN) mainly focus on cardiac intervention and rarely focus on patients undergoing urological contrast investigations. We aimed to determine the association and effect of intravenous (IV) iodinated contrast material on the incidence of CIN in a group of patients undergoing urology investigation and compare the results with that of cardiology interventions.Methods:This prospective study was performed in patients undergoing IV contrast studies in Urology and those undergoing coronary interventions, in our institution for 1 year. Association between the occurrence of CIN and the risk factors such as age (≥60 years), sex, diabetes mellitus, hypertension, anemia, left ventricular ejection fraction <40%, estimated glomerular filtration rate (eGFR), and volume of contrast used were studied using Chi-square tests or Fisher exact test and Student's t-test.Results:A total of 339 cases (168 urology and 171 cardiology) were studied. CIN was noted in 8.3% of urology patients whereas it was 29.8% in cardiology patients. In urology patients, statistically significant association was noted between CIN and eGFR <60 ml/min/1.73 m2 and volume of contrast used. In cardiology patients, statistically significant association (P < 0.05) was noted for diabetes, hypertension, eGFR <60 ml/min/1.73 m2, volume of contrast used.Conclusion:Although CIN was found to occur with contrast studies, the deleterious effects of contrast in urological procedures were lower than cardiology patients. The association between the occurrence of CIN and patient factors were also different in the two groups.

Prostate cancer is among the top ten cancers in India. Approximately half of patients with prostate cancer have metastasis on presentation, bones and regional lymph nodes being most common. A case of metastasised cancer of prostate presenting only with an inguinal mass without any other symptom is rare. A 72-year-old presented with a right inguinal mass for six months without any other complaints. Biopsy of the inguinal mass was done, and histopathology showed metastatic adenocarcinoma. His serum PSA (prostate specific antigen) was 117.325 ng/ml. PET CT (positron emission tomography-computed tomography) showed PSMA (prostate specific membrane antigen) expressing lesion in left lobe of prostate involving left seminal with metastatic pelvic, right inguinal, retroperitoneal and mediastinal adenopathy with increased tracer uptake in sclerotic skeletal lesions in right iliac bone, acetabulum and right femoral shaft. TRUS (trans rectal ultra-sonography) guided biopsy of prostate (12 CORE) was performed and showed conventional prostatic adenocarcinoma with maximum Gleason score 4+4=8, grade group IV. The patient's clinical stage was T3b N1 Mb. Patient is currently on abiraterone with degarelix with normal repeat serum PSA (0.067 ng/ml) on follow up at 5 months. Metastatic prostatic carcinoma usually presents with iliac nodes or bony metastasis, but rarely they present with inguinal lymphadenopathy and should be dealt with high clinical suspicion as they are already in advanced stage of the disease process.