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Renal adenomas: pathological differential diagnosis with malignant tumors.

Algaba F - Adv Urol (2008)

Bottom Line: The renal adenomas can be confused by imaging diagnosis with malignant renal tumors, but there are also real biological dilemmas to determine their behavior.The consensus decisions are the following. (1) The adenoma of clear cells is not accepted, instead it is considered that all the clear-cell tumors are carcinomas, with greater or lesser aggressiveness. (2) Among the papillary neoplasms the WHO 2004 renal cell tumors classification are considered as papillary adenomas tumors with a maximum diameter of 5 mm and may represent a continuum biological process to papillary renal cell carcinoma.The papillary adenomas associated with End-kidney and/or acquired cystic disease may have a different pathogenesis. (3) To consider a tumor as an oncocytoma the size is not important, only the cytological features, microscopic, ultrastructural, and immunohistochemically can help, but some chromosomal observations introduce some questions about its relation with the chromophobe renal cell carcinoma. (4) Finally, the metanephric adenoma, a tumor with some morphological similarity with the nephroblastoma must be considered in the renal adenomas diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Pathology section, Fundació Puigvert, Universitat Autónoma de Barcelona (UAB), 08025 Barcelona, Spain. falgaba@fundacio-puivert.es

ABSTRACT
The renal adenomas can be confused by imaging diagnosis with malignant renal tumors, but there are also real biological dilemmas to determine their behavior. The consensus decisions are the following. (1) The adenoma of clear cells is not accepted, instead it is considered that all the clear-cell tumors are carcinomas, with greater or lesser aggressiveness. (2) Among the papillary neoplasms the WHO 2004 renal cell tumors classification are considered as papillary adenomas tumors with a maximum diameter of 5 mm and may represent a continuum biological process to papillary renal cell carcinoma. The papillary adenomas associated with End-kidney and/or acquired cystic disease may have a different pathogenesis. (3) To consider a tumor as an oncocytoma the size is not important, only the cytological features, microscopic, ultrastructural, and immunohistochemically can help, but some chromosomal observations introduce some questions about its relation with the chromophobe renal cell carcinoma. (4) Finally, the metanephric adenoma, a tumor with some morphological similarity with the nephroblastoma must be considered in the renal adenomas diagnosis.

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(a) Oncocitomas, (b) eosinophilic chromophobe renal cell carcinoma variant. Notice the similar aspect that both lesions can present.
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fig3: (a) Oncocitomas, (b) eosinophilic chromophobe renal cell carcinoma variant. Notice the similar aspect that both lesions can present.

Mentions: The problem originates in thecytological characteristics that at times are difficult to distinguish fromother neoplasias of eosinophilic cells, such as the clear-cell renal carcinomaseosinophilic variant and especially the chromophobe eosinophilic carcinomas(Figure 3).


Renal adenomas: pathological differential diagnosis with malignant tumors.

Algaba F - Adv Urol (2008)

(a) Oncocitomas, (b) eosinophilic chromophobe renal cell carcinoma variant. Notice the similar aspect that both lesions can present.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2563151&req=5

fig3: (a) Oncocitomas, (b) eosinophilic chromophobe renal cell carcinoma variant. Notice the similar aspect that both lesions can present.
Mentions: The problem originates in thecytological characteristics that at times are difficult to distinguish fromother neoplasias of eosinophilic cells, such as the clear-cell renal carcinomaseosinophilic variant and especially the chromophobe eosinophilic carcinomas(Figure 3).

Bottom Line: The renal adenomas can be confused by imaging diagnosis with malignant renal tumors, but there are also real biological dilemmas to determine their behavior.The consensus decisions are the following. (1) The adenoma of clear cells is not accepted, instead it is considered that all the clear-cell tumors are carcinomas, with greater or lesser aggressiveness. (2) Among the papillary neoplasms the WHO 2004 renal cell tumors classification are considered as papillary adenomas tumors with a maximum diameter of 5 mm and may represent a continuum biological process to papillary renal cell carcinoma.The papillary adenomas associated with End-kidney and/or acquired cystic disease may have a different pathogenesis. (3) To consider a tumor as an oncocytoma the size is not important, only the cytological features, microscopic, ultrastructural, and immunohistochemically can help, but some chromosomal observations introduce some questions about its relation with the chromophobe renal cell carcinoma. (4) Finally, the metanephric adenoma, a tumor with some morphological similarity with the nephroblastoma must be considered in the renal adenomas diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Pathology section, Fundació Puigvert, Universitat Autónoma de Barcelona (UAB), 08025 Barcelona, Spain. falgaba@fundacio-puivert.es

ABSTRACT
The renal adenomas can be confused by imaging diagnosis with malignant renal tumors, but there are also real biological dilemmas to determine their behavior. The consensus decisions are the following. (1) The adenoma of clear cells is not accepted, instead it is considered that all the clear-cell tumors are carcinomas, with greater or lesser aggressiveness. (2) Among the papillary neoplasms the WHO 2004 renal cell tumors classification are considered as papillary adenomas tumors with a maximum diameter of 5 mm and may represent a continuum biological process to papillary renal cell carcinoma. The papillary adenomas associated with End-kidney and/or acquired cystic disease may have a different pathogenesis. (3) To consider a tumor as an oncocytoma the size is not important, only the cytological features, microscopic, ultrastructural, and immunohistochemically can help, but some chromosomal observations introduce some questions about its relation with the chromophobe renal cell carcinoma. (4) Finally, the metanephric adenoma, a tumor with some morphological similarity with the nephroblastoma must be considered in the renal adenomas diagnosis.

No MeSH data available.


Related in: MedlinePlus