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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

Unenhanced (left) and portal venous phase (right) CT shows an extensive multicystic mass (arrows) bulging the renal capsule at multiple sites
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Figure 2: Unenhanced (left) and portal venous phase (right) CT shows an extensive multicystic mass (arrows) bulging the renal capsule at multiple sites

Mentions: CT image features suggestive of MCN are multicystic architecture [Figure 2] with well-defined margins, enhancing septae and herniation into renal pelvis. This herniation often causes hematuria. However, it is interesting to note that the two cases in this series presenting with hematuria did not show any herniation in CT imaging. Calcification is rarely seen; occasionally, however, ossification can occur within septa or within the renal capsule. Central or small peripheral curvilinear calcifications can occasionally be seen at the edge of the herniated pelvic portion.[20] In addition, dense calcium rings in multiple cysts have been reported.[4] If present, calcification may lead to confusion with malignancy as case no. 1 in the present series was reported as a T2 lesion on CT.


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)

Unenhanced (left) and portal venous phase (right) CT shows an extensive multicystic mass (arrows) bulging the renal capsule at multiple sites
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Unenhanced (left) and portal venous phase (right) CT shows an extensive multicystic mass (arrows) bulging the renal capsule at multiple sites
Mentions: CT image features suggestive of MCN are multicystic architecture [Figure 2] with well-defined margins, enhancing septae and herniation into renal pelvis. This herniation often causes hematuria. However, it is interesting to note that the two cases in this series presenting with hematuria did not show any herniation in CT imaging. Calcification is rarely seen; occasionally, however, ossification can occur within septa or within the renal capsule. Central or small peripheral curvilinear calcifications can occasionally be seen at the edge of the herniated pelvic portion.[20] In addition, dense calcium rings in multiple cysts have been reported.[4] If present, calcification may lead to confusion with malignancy as case no. 1 in the present series was reported as a T2 lesion on CT.

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