Difference between revisions of "Papillary adenoma of the kidney"

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| Caption    = Papillary adenoma. [[H&E stain]].
| Caption    = Papillary adenoma. [[H&E stain]].
| Synonyms  = papillary adenoma, renal papillary adenoma
| Synonyms  = papillary adenoma, renal papillary adenoma
| Micro      = papillae typically with foam cells, +/-psammoma bodies, nuclei usu. low grade
| Micro      = papillae typically with foam cells, +/-psammoma bodies, low [[ISUP nucleolar grade]], ''must'' be <=1.5 cm
| Subtypes  =
| Subtypes  =
| LMDDx      = [[papillary renal cell carcinoma]], [[metanephric adenoma]]
| LMDDx      = [[papillary renal cell carcinoma]], [[metanephric adenoma]]
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| Molecular  =
| Molecular  =
| IF        =
| IF        =
| Gross      = '''must''' be <=0.5 cm, typically cortical lesion
| Gross      = typically subcapsular location
| Grossing  =
| Grossing  =
| Site      = [[kidney]] - see ''[[kidney tumours]]''
| Site      = [[kidney]] - see ''[[kidney tumours]]''
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**Stains like PaRCC.
**Stains like PaRCC.
**Found with an increased frequency within the content of PaRCC.
**Found with an increased frequency within the content of PaRCC.
Note:
*In the kidney, the concept of ''[[adenoma]]'' only exists for papillary lesions that are [[papillary RCC]]-like. Small lesions that are [[chromophobe RCC]]-like or [[clear cell RCC]]-like are carcinomas.<ref name=pmid18846240/>


==Gross==
==Gross==
*Cortical kidney lesion '''must''' be <=0.5 cm.
*Cortical kidney lesion.
**Typically subcapsular location.
**Usually subcapsular.


==Microscopic==
==Microscopic==
Features:
Features:
#Histomorphology of ''[[papillary renal cell carcinoma]]''.
#Histomorphology of ''[[papillary renal cell carcinoma]]'' with low [[ISUP nucleolar grade]] (grade 1 or 2).
#'''''Must''''' be <=0.5 cm.<ref name=Ref_GUP288>{{Ref GUP|288}}</ref><ref name=pmid18846240>{{Cite journal  | last1 = Algaba | first1 = F. | title = Renal adenomas: pathological differential diagnosis with malignant tumors. | journal = Adv Urol | volume =  | issue =  | pages = 974848 | month = | year = 2008 | doi = 10.1155/2008/974848 | PMID = 18846240 | PMC = 2563151 | URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563151/?tool=pubmed }}</ref>
#''Must'' be <=1.5 cm as per 2016 WHO classification.<ref name=pmid26935559>{{Cite journal  | last1 = Moch | first1 = H. | last2 = Cubilla | first2 = AL. | last3 = Humphrey | first3 = PA. | last4 = Reuter | first4 = VE. | last5 = Ulbright | first5 = TM. | title = The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours. | journal = Eur Urol | volume =  | issue =  | pages = | month = Feb | year = 2016 | doi = 10.1016/j.eururo.2016.02.029 | PMID = 26935559 }}</ref>
#*[[Diagnostic size cutoff]] - larger lesions are ''papillary renal cell carcinoma''.
#*[[Diagnostic size cutoff]] - larger lesions are ''papillary renal cell carcinoma''.
Note:
*The size cut-off used to be <=0.5 cm.<ref name=pmid26935559/><ref name=Ref_GUP288>{{Ref GUP|288}}</ref><ref name=pmid18846240>{{Cite journal  | last1 = Algaba | first1 = F. | title = Renal adenomas: pathological differential diagnosis with malignant tumors. | journal = Adv Urol | volume =  | issue =  | pages = 974848 | month =  | year = 2008 | doi = 10.1155/2008/974848 | PMID = 18846240 | PMC = 2563151 | URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563151/?tool=pubmed }}</ref>


DDx:
DDx:
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==IHC==
==IHC==
*CK7 +ve.
*AMACR +ve.<ref name=pmid17056094/>
*AMACR +ve.<ref name=pmid17056094/>


Latest revision as of 12:57, 23 June 2016

Papillary adenoma of the kidney
Diagnosis in short

Papillary adenoma. H&E stain.
Synonyms papillary adenoma, renal papillary adenoma
LM papillae typically with foam cells, +/-psammoma bodies, low ISUP nucleolar grade, must be <=1.5 cm
LM DDx papillary renal cell carcinoma, metanephric adenoma
IHC AMACR +ve
Gross typically subcapsular location
Site kidney - see kidney tumours
Associated Dx often seen with papillary renal cell carcinoma
Clinical history often an incidental finding
Prevalence common
Prognosis benign
Clin. DDx other renal tumours
Treatment observation

Papillary adenoma of the kidney, also renal papillary adenoma, is a benign kidney tumour related to papillary renal cell carcinoma.

General

Note:

Gross

  • Cortical kidney lesion.
    • Usually subcapsular.

Microscopic

Features:

  1. Histomorphology of papillary renal cell carcinoma with low ISUP nucleolar grade (grade 1 or 2).
  2. Must be <=1.5 cm as per 2016 WHO classification.[3]

Note:

  • The size cut-off used to be <=0.5 cm.[3][4][2]

DDx:

Images

  • PA - very low mag.

  • PA - low mag.

  • PA - intermed. mag.

  • PA - intermed. mag.

  • PA - high mag.

www:

IHC

  • CK7 +ve.
  • AMACR +ve.[1]

See also

References

  1. ↑ 1.0 1.1 Wang, KL.; Weinrach, DM.; Luan, C.; Han, M.; Lin, F.; Teh, BT.; Yang, XJ. (Feb 2007). "Renal papillary adenoma--a putative precursor of papillary renal cell carcinoma.". Hum Pathol 38 (2): 239-46. doi:10.1016/j.humpath.2006.07.016. PMID 17056094.
  2. ↑ 2.0 2.1 2.2 Algaba, F. (2008). "Renal adenomas: pathological differential diagnosis with malignant tumors.". Adv Urol: 974848. doi:10.1155/2008/974848. PMC 2563151. PMID 18846240. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563151/.
  3. ↑ 3.0 3.1 Moch, H.; Cubilla, AL.; Humphrey, PA.; Reuter, VE.; Ulbright, TM. (Feb 2016). "The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours.". Eur Urol. doi:10.1016/j.eururo.2016.02.029. PMID 26935559.
  4. ↑ Zhou, Ming; Magi-Galluzzi, Cristina (2006). Genitourinary Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 288. ISBN 978-0443066771.
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