Metanephric adenoma

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Metanephric adenoma is a benign tumour of the kidney.

Metanephric adenoma
Diagnosis in short

Metanephric adenoma. H&E stain.

LM small uniform cells with fine chromatin, no apparent nucleolus, and a relatively smooth nuclear membrane; variable architecture - may be sheets, ductal or micropapillary, +/-psammoma bodies
LM DDx Wilms tumour, papillary renal cell carcinoma (type 1)
IHC WT-1 +ve, CD57 +ve, AMACR -ve, CD56 -ve
Site kidney - see kidney tumours

Clinical history usu. adults, occasionally children
Prevalence uncommon
Prognosis good, benign

It should not be confused mesonephric adenoma, another term for nephrogenic adenoma.

This can be remembered as follows: metanephric adenoma is a tumour.

General

  • Benign.
  • Afflicts adults and occasionally children.
  • May be associated with polycythemia.[1]

Gross

  • Sharply circumscribed.
  • Not encapsulated.

Microscopic

Features:[2]

  • Small uniform cells with:
    • Fine chromatin.
    • No apparent nucleolus.
    • A relatively smooth nuclear membrane.
  • Variable architecture - may be sheets, ductal or micropapillary.
  • +/-Psammoma bodies.

DDx:

Images

www:

IHC

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Left Kidney, Total Nephrectomy:
- Metanephric adenoma, see comment.

COMMENT:
The tumour stains as follows:
POSITIVE: WT1, CD57, PAX8.
NEGATIVE: CD56, TTF-1, AMACR.

See also

References

  1. Le Nué, R.; Marcellin, L.; Ripepi, M.; Henry, C.; Kretz, JM.; Geiss, S. (Aug 2011). "Conservative treatment of metanephric adenoma. A case report and review of the literature.". J Pediatr Urol 7 (4): 399-403. doi:10.1016/j.jpurol.2010.09.010. PMID 21220212.
  2. 2.0 2.1 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 284. ISBN 978-0781765275.
  3. 3.0 3.1 3.2 Watanabe, S.; Naganuma, H.; Shimizu, M.; Ota, S.; Murata, S.; Nihei, N.; Matsushima, J.; Mikami, S. et al. (2013). "Adult nephroblastoma with predominant epithelial component: a differential diagnostic candidate of papillary renal cell carcinoma and metanephric adenoma-report of three cases.". Case Rep Pathol 2013: 675875. doi:10.1155/2013/675875. PMID 24083046.
  4. 4.0 4.1 4.2 Muir, TE.; Cheville, JC.; Lager, DJ. (Oct 2001). "Metanephric adenoma, nephrogenic rests, and Wilms' tumor: a histologic and immunophenotypic comparison.". Am J Surg Pathol 25 (10): 1290-6. PMID 11688464.

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