@entity703 . The seventh sickle cell XXXX .

@entity1 @entity8 @entity13654 @entity5 @entity5720 @entity3458 @entity1188 @entity2885 @entity1985 @entity811 @entity703
Over the last 22 years, we have encountered 34 examples of a highly aggressive @entity5 with a microscopic morphology that is highly predictive of finding sickled erythrocytes in the tissue. With the exception of one @entity1 , all are believed to have had sickle cell trait or, in one case, @entity13654 . These 33 @entity1 are the subject of this report and, where their race was known, they were all blacks between the ages of 11 and 39 years. Between the ages of 11 and 24 years, males predominated by 3 to 1. Beyond age 24, however, the @entity5 occurred equally in @entity1 and @entity1 . The dominant @entity5 mass was in the medulla and ranged from 4 to 12 cm in diameter. Mean size was 7 cm; median, 6 cm. Peripheral satellites in the renal cortex and pelvic soft tissues, as well as venous and lymphatic invasion, were usually present. The lesions exhibited a reticular, yolk sac-like, or adenoid cystic appearance, often with poorly differentiated areas in a highly desmoplastic stroma admixed with neutrophils and usually marginated by lymphocytes. The @entity5 had usually metastasized when first discovered, and none was confined to the kidney at the time of nephrectomy. The mean duration of life after surgery was 15 weeks. These @entity5 probably arise in the calyceal epithelium in or near the @entity8 , the same site that produces the more familiar picture of unilateral @entity811 in @entity1 with sickle cell trait. We have concluded that @entity703 represents another example of @entity8 associated with @entity3458 . The other six are unilateral @entity811 , @entity5720 , @entity1985 , @entity1188 , inability to concentrate urine, and @entity2885 .
