INTRAGLOMERULAR METASTASIS WITH NEOPLASTIC CELL INTERPOSITION - CASE-REPORT

A case is described of an 88-year-old man with lung cancer, nephrotic syndrome, and renal dysfunction who died suddenly of an acute myocardi al infarction and whose autopsy revealed many adenocarcinoma cells sta cked within glomerular capillary lumina of his kidney, entering into b asement membrane zones (ie, neoplastic cell interposition), In additio n, glomeruli showed a lobular transformation, doubling of glomerular b asement membrane, and electron dense deposits along the glomerular bas ement membrane, These changes were similar to those of membranoprolife rative glomerulonephritis, The association of intraglomerular metastas is and membranoproliferative glomerulonephritis-like lesions led the a uthors to speculate that the latter glomerular change might have provi ded an attractive opportunity for circulating tumor cells to be trappe d and grow within the glomerular lumina, This mode of metastasis has n ot been well-recognized. The authors describe the experience, review t he literature, and discuss its possible pathogenesis.