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Adult multilocular cystic nephroma: Report of six cases with clinical, radio-pathologic correlation and review of literature.

Wilkinson C, Palit V, Bardapure M, Thomas J, Browning AJ, Gill K, Biyani CS - Urol Ann (2013)

Bottom Line: No cells with clear cytoplasm, blastemal or immature elements were seen.In one case, foci of inflammatory cells and histiocytes were present.MCN is a benign cystic lesion and clinical presentations are nonspecific with symptoms such as abdominal pain, hematuria and urinary tract infection.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Pinderfields General Hospital, Wakefield, West Yorkshire, UK.

ABSTRACT

Background: Cystic renal neoplasms of the kidney can be benign or malignant. Multicystic nephroma (MCN) represents a rare benign cystic lesion of the kidney, which usually presents as a unilateral multicystic renal mass without solid elements. According to the World Health Organization (WHO) classification of the renal neoplasms, it is grouped along with mixed epithelial-stromal tumor of the kidney.

Materials and methods: We report a retrospective review of six cases of MCN of kidney. Patient demographics, imaging findings, operative details and final histology were recorded.

Results: All patients had suspicious/malignant features on radiological examination, leading to a radical nephrectomy. However, microscopically these lesions were lined by cuboidal epithelium, and in a few places hobnail epithelium. No cells with clear cytoplasm, blastemal or immature elements were seen. In one case, foci of inflammatory cells and histiocytes were present.

Conclusions: MCN is a benign cystic lesion and clinical presentations are nonspecific with symptoms such as abdominal pain, hematuria and urinary tract infection. These nonspecific clinical presentations and confusing radiological features create difficult preoperative differentiation from malignant cystic renal neoplasms.

No MeSH data available.


Related in: MedlinePlus

Ultrasound of the right kidney. Longitudinal (left) and transverse (right) images show a well-defined multiseptated cystic lesion (arrows) at the lower pole
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Figure 1: Ultrasound of the right kidney. Longitudinal (left) and transverse (right) images show a well-defined multiseptated cystic lesion (arrows) at the lower pole

Mentions: Distinct radiographic features have been described [Table 2], but are not universally present in all cases. Ultrasound is often the first investigation used in evaluating abdominal masses, confirmed by CT scan. The sonographic findings depend on the amount of stromal tissue and size of locules. Cysts usually show up as hypoechoic lesions delineated by hyperechoic septae [Figure 1], and this feature can be suggestive of MCN but not diagnostic. The mass is often easily demonstrable at ultrasound, with an average diameter of approximately 10 cm.[18] Our six cases had a mean maximum diameter of 8.9 cm. If the cysts are small, the mass may demonstrate internal scattered echoes but without distinct loculations.[3] Calcification has been described as a rare feature of MCN,[6] and curvilinear calcifications may be seen on ultrasound within the septa. None of our patients displayed calcification within the MCN on any imaging modality. If present, as in one of our cases, urinary obstruction may be well demonstrated with ultrasound. Both needle-guided aspiration and color Doppler ultrasound have been proposed to help differentiate between benign and malignant multilocular cystic lesions.[19]


Adult multilocular cystic nephroma: Report of six cases with clinical, radio-pathologic correlation and review of literature.

Wilkinson C, Palit V, Bardapure M, Thomas J, Browning AJ, Gill K, Biyani CS - Urol Ann (2013)

Ultrasound of the right kidney. Longitudinal (left) and transverse (right) images show a well-defined multiseptated cystic lesion (arrows) at the lower pole
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3643315&req=5

Figure 1: Ultrasound of the right kidney. Longitudinal (left) and transverse (right) images show a well-defined multiseptated cystic lesion (arrows) at the lower pole
Mentions: Distinct radiographic features have been described [Table 2], but are not universally present in all cases. Ultrasound is often the first investigation used in evaluating abdominal masses, confirmed by CT scan. The sonographic findings depend on the amount of stromal tissue and size of locules. Cysts usually show up as hypoechoic lesions delineated by hyperechoic septae [Figure 1], and this feature can be suggestive of MCN but not diagnostic. The mass is often easily demonstrable at ultrasound, with an average diameter of approximately 10 cm.[18] Our six cases had a mean maximum diameter of 8.9 cm. If the cysts are small, the mass may demonstrate internal scattered echoes but without distinct loculations.[3] Calcification has been described as a rare feature of MCN,[6] and curvilinear calcifications may be seen on ultrasound within the septa. None of our patients displayed calcification within the MCN on any imaging modality. If present, as in one of our cases, urinary obstruction may be well demonstrated with ultrasound. Both needle-guided aspiration and color Doppler ultrasound have been proposed to help differentiate between benign and malignant multilocular cystic lesions.[19]

Bottom Line: No cells with clear cytoplasm, blastemal or immature elements were seen.In one case, foci of inflammatory cells and histiocytes were present.MCN is a benign cystic lesion and clinical presentations are nonspecific with symptoms such as abdominal pain, hematuria and urinary tract infection.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Pinderfields General Hospital, Wakefield, West Yorkshire, UK.

ABSTRACT

Background: Cystic renal neoplasms of the kidney can be benign or malignant. Multicystic nephroma (MCN) represents a rare benign cystic lesion of the kidney, which usually presents as a unilateral multicystic renal mass without solid elements. According to the World Health Organization (WHO) classification of the renal neoplasms, it is grouped along with mixed epithelial-stromal tumor of the kidney.

Materials and methods: We report a retrospective review of six cases of MCN of kidney. Patient demographics, imaging findings, operative details and final histology were recorded.

Results: All patients had suspicious/malignant features on radiological examination, leading to a radical nephrectomy. However, microscopically these lesions were lined by cuboidal epithelium, and in a few places hobnail epithelium. No cells with clear cytoplasm, blastemal or immature elements were seen. In one case, foci of inflammatory cells and histiocytes were present.

Conclusions: MCN is a benign cystic lesion and clinical presentations are nonspecific with symptoms such as abdominal pain, hematuria and urinary tract infection. These nonspecific clinical presentations and confusing radiological features create difficult preoperative differentiation from malignant cystic renal neoplasms.

No MeSH data available.


Related in: MedlinePlus