Telocytes, c-Kit positive cells, Smooth muscles, and collagen in the ureter of pediatric patients with congenital primary obstructive megaureter: elucidation of etiopathology

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Wishahi M.; Hafiz E.; Wishahy A.M.K.; Badawy M.

Journal: Ultrastructural Pathology

Publisher: Taylor and Francis Ltd.

Publication Date: 27 July 2021

Volume / Issue: Volume 45 / Issue 3

Pages: 257–265

ISSN: 1913123

DOI: 10.1080/01913123.2021.1954734

Scopus: View on Scopus

PubMed: 34315317

Document Type: Article

Authors and Affiliations

Wishahi M., Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt; Hafiz E., Clinical Laboratory Department, Electron Microscopy Laboratory, Theodor Bilharz Research Institute, Cairo, Egypt; Wishahy A.M.K., Department of Pediatric Surgery- Faculty of Medicine, Cairo University, Cairo, Egypt; Badawy M., Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt

Abstract

Congenital primary obstructive megaureter (POM) is an uncommon pediatric anomaly that is due to obstructive distal ureter leading to the loss of peristalsis with consequent ureterohydronephrosis causing loss of kidney function. The objectives are to elucidate the etiology of POM by demonstrating the presence of interstitial cells of Cajal (ICC), telocytes, smooth muscles, and collage in the obstructive and dilated ureteral segments. The study was carried out on 15 surgical specimens of congenital POM in pediatric patients, age range was 4 to 24 months, they were operated upon by excision of the obstructed segment, tailoring the dilated ureter, and anastomosing it to the bladder. Specimens included the obstructed ureteral segment and part of the dilated ureter. Specimens were examined with hematoxylin and eosin (H&E) stain, Modified Gomori trichrome stain, immunohistochemistry (IHC) with α-muscle actin, and c-kit (CD117), and transmission electron microscopy (TEM). Obstructed segment showed excess collagen intervening between smooth muscles, excess c-Kit positive cells, and presence of telocytes. The dilated segment of the ureteral wall is formed of smooth muscle bundles with scanty collagen. Staining with c-Kit did not demonstrate positive cells. TEM showed myofibroblasts and close adherence of smooth muscle cells to each other with absence of telocytes. The pathophysiology of POM is multifactorial. Loss of interstitial cells and rarity of collagen result in loss of elasticity of dilated segment leading to massive dilatation. While the obstructed segment had no muscle conductivity due to excess collagen irrespective of presence of telocytes. © 2021 Taylor & Francis Group, LLC.

Keywords

c-kit; collagen; electron microscopy; megaureter; smooth muscles; Urinary tract; Child; Child, Preschool; Humans; Infant; Muscle, Smooth; Myocytes, Smooth Muscle; Telocytes; Ureter; human; preschool child; smooth muscle; smooth muscle cell; surgery; telocyte

Citation Information

Scopus Citations: 8

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