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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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Metanephric adenoma. microacinar structures of basophilic cells with a nephroblastic appearance.
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fig5: Metanephric adenoma. microacinar structures of basophilic cells with a nephroblastic appearance.

Mentions: Arelatively short time ago a tumor was introduced among the renal adenomas thatwas comprised by small cells with scant cytoplasma, uniform, without mitosis,embryonic-appearing, distributed in small round acini with a phenotype similar tothe nephroblastoma (Figure 5). They represent 1% of localized tumors of less than 7 cm. The mean age is 41 years(from 5 to 83 years). Fifty percent are incidentaland 10% have a polycythemia. Immunohistochemistry,the WT1, CD 56, and CD 57 are positive and the AMACR is negative [12].


Renal adenomas: pathological differential diagnosis with malignant tumors.

Algaba F - Adv Urol (2008)

Metanephric adenoma. microacinar structures of basophilic cells with a nephroblastic appearance.
© Copyright Policy
Related In: Results  -  Collection

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

fig5: Metanephric adenoma. microacinar structures of basophilic cells with a nephroblastic appearance.
Mentions: Arelatively short time ago a tumor was introduced among the renal adenomas thatwas comprised by small cells with scant cytoplasma, uniform, without mitosis,embryonic-appearing, distributed in small round acini with a phenotype similar tothe nephroblastoma (Figure 5). They represent 1% of localized tumors of less than 7 cm. The mean age is 41 years(from 5 to 83 years). Fifty percent are incidentaland 10% have a polycythemia. Immunohistochemistry,the WT1, CD 56, and CD 57 are positive and the AMACR is negative [12].

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