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Peer-reviewedCC BY-NC-NDIJU case reports

Longitudinal Changes in Stone Composition and Histopathological and Proteomic Characterization of a Matrix Stone: A Case Report

  • Yuki Hideo1
  • Naoyuki Otani2,3
  • Shota Umezawa1
  • Yasuhiro Horibata4
  • Akimitsu Konishi4
4 affiliations
  1. 1Department of Urology Dokkyo Medical University Nikko Medical Center Nikko Japan
  2. 2Department of Cardiology Dokkyo Medical University Nikko Medical Center Nikko Japan
  3. 3Department of Cardiology NHO Yonago Medical Center Yonago Japan
  4. 4Department of Biochemistry Dokkyo Medical University Mibu Japan
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Abstract

Introduction: Matrix stones are rare urinary calculi composed predominantly of organic matrix, with poorly understood pathogenesis. We herein report a case involving refractory matrix stones with longitudinal compositional changes and characterize the final specimen using histopathological and proteomic analyses.

Case Presentation: A 54‐year‐old woman with long‐standing nephrolithiasis developed bilateral ureteral obstruction and recurrent pyelonephritis, requiring multiple transurethral ureterolithotripsy procedures, ureteral stenting, and percutaneous nephrostomy. Stone composition changed sequentially from predominantly calcium oxalate to struvite to proteinaceous (consistent with matrix stones). Histopathology revealed predominantly acellular eosinophilic material, minimal mucopolysaccharide deposition, phosphotungstic acid hematoxylin‐positive material suggestive of fibrin, and myeloperoxidase‐positive material within the matrix. Repeated liquid chromatography–tandem mass spectrometry reproducibly identified multiple neutrophil‐associated proteins.

Conclusion: This report documents longitudinal changes preceding matrix stone development, suggesting an association between changes in stone composition and a sustained inflammatory and infectious milieu.

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Cite

BibTeXRIS
BibTeX
@article{hideo2026longitudinal,
  title = {{Longitudinal Changes in Stone Composition and Histopathological and Proteomic Characterization of a Matrix Stone: A Case Report}},
  author = {Yuki Hideo and Naoyuki Otani and Shota Umezawa and Yasuhiro Horibata and Akimitsu Konishi},
  journal = {IJU case reports},
  year = {2026},
  month = nov,
  doi = {10.1002/iju5.70295},
  url = {https://europepmc.org/article/PMC/PMC13727893},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Longitudinal Changes in Stone Composition and Histopathological and Proteomic Characterization of a Matrix Stone: A Case Report
AU  - Yuki Hideo
AU  - Naoyuki Otani
AU  - Shota Umezawa
AU  - Yasuhiro Horibata
AU  - Akimitsu Konishi
PY  - 2026
DA  - 2026/11/01
JO  - IJU case reports
DO  - 10.1002/iju5.70295
UR  - https://europepmc.org/article/PMC/PMC13727893
AB  - Introduction: Matrix stones are rare urinary calculi composed predominantly of organic matrix, with poorly understood pathogenesis. We herein report a case involving refractory matrix stones with longitudinal compositional changes and characterize the final specimen using histopathological and proteomic analyses.  Case Presentation: A 54‐year‐old woman with long‐standing nephrolithiasis developed bilateral ureteral obstruction and recurrent pyelonephritis, requiring multiple transurethral ureterolithotripsy procedures, ureteral stenting, and percutaneous nephrostomy. Stone composition changed sequentially from predominantly calcium oxalate to struvite to proteinaceous (consistent with matrix stones). Histopathology revealed predominantly acellular eosinophilic material, minimal mucopolysaccharide deposition, phosphotungstic acid hematoxylin‐positive material suggestive of fibrin, and myeloperoxidase‐positive material within the matrix. Repeated liquid chromatography–tandem mass spectrometry reproducibly identified multiple neutrophil‐associated proteins.  Conclusion: This report documents longitudinal changes preceding matrix stone development, suggesting an association between changes in stone composition and a sustained inflammatory and infectious milieu.
SN  - 2577-171X
ER  -