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, | | 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]] | ||
| Line 13: | Line 13: | ||
| Molecular = | | Molecular = | ||
| IF = | | IF = | ||
| Gross = | | Gross = typically subcapsular location | ||
| Grossing = | | Grossing = | ||
| Site = [[kidney]] - see ''[[kidney tumours]]'' | | Site = [[kidney]] - see ''[[kidney tumours]]'' | ||
| Assdx = often seen with [[papillary renal cell carcinoma]] | | Assdx = often seen with [[papillary renal cell carcinoma]] | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = often an incidental finding | | Clinicalhx = often an incidental finding | ||
| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = | ||
| Line 37: | Line 37: | ||
**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== | |||
*Cortical kidney lesion. | |||
**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 <=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: | ||
| Line 60: | Line 70: | ||
==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
- Benign.
- Considered a precursor for papillary renal cell carcinoma (PaRCC).[1]
- Stains like 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.[2]
Gross
- Cortical kidney lesion.
- Usually subcapsular.
Microscopic
Features:
- Histomorphology of papillary renal cell carcinoma with low ISUP nucleolar grade (grade 1 or 2).
- Must be <=1.5 cm as per 2016 WHO classification.[3]
- Diagnostic size cutoff - larger lesions are papillary renal cell carcinoma.
Note:
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
- ↑ 1.0 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.
- ↑ 2.0 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/.
- ↑ 3.0 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.
- ↑ 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.