Mixed epithelial and stromal tumour of the kidney
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| Mixed epithelial and stromal tumour of the kidney | |
|---|---|
| Diagnosis in short | |
 Mixed epithelial stromal tumour of kidney. H&E stain. | |
|
| |
| LM | cysts lined by simple epithelium with hobnailing, stroma has an ovarian look (basophilic, spindle cells) |
| LM DDx | cystic nephroma, tubulocystic renal cell carcinoma |
| IHC | ER +ve, PR +ve, CD10 +ve |
| Gross | renal mass, predominantly solid |
| Grossing notes | total nephrectomy for tumour grossing, partial nephrectomy grossing |
| Site | kidney - see kidney tumour |
|
| |
| Prevalence | rare |
| Prognosis | benign |
Mixed epithelial and stromal tumour of the kidney, abbreviated MEST, is a rare benign kidney tumour in the WHO classification of renal neoplasia.
Turbiner et al.[1] have suggested that cystic nephroma and mixed epithelial and stromal tumour (MEST) are one tumour; the proposed lumping term renal epithelial and stromal tumour, abbreviated REST.
General
- Rare - approximately 1.5% of renal neoplasms.[2]
- Benign.
- Prevalence: males > females.
Gross
- Solid and cystic mass - predominantly solid.
Microscopic
Features:
- Cysts lined by simple epithelium with hobnailing - key feature.
- Stroma has an ovarian look:
- Blue (basophilic).
- Spindle cells.
Notes:
- Parenchymal elements (e.g. glomueruli, tubules) are not found in the septa between the cysts.
DDx:
- Cystic nephroma - more cystic.
- Tubulocystic renal cell carcinoma - has high grade nucleoli.
Images
MEST - low mag.
MEST - intermed. mag.
MEST - high mag.
MEST - high mag.
MEST - very high mag.
IHC
Features:[2]
- ER +ve.
- PR +ve.
- CD10 +ve.
See also
References
- ↑ Turbiner, J.; Amin, MB.; Humphrey, PA.; Srigley, JR.; De Leval, L.; Radhakrishnan, A.; Oliva, E. (Apr 2007). "Cystic nephroma and mixed epithelial and stromal tumor of kidney: a detailed clinicopathologic analysis of 34 cases and proposal for renal epithelial and stromal tumor (REST) as a unifying term.". Am J Surg Pathol 31 (4): 489-500. doi:10.1097/PAS.0b013e31802bdd56. PMID 17414095.
- ↑ 2.0 2.1 Mai, KT.; Elkeilani, A.; Veinot, JP. (Apr 2007). "Mixed epithelial and stromal tumour (MEST) of the kidney: report of 14 cases with male and PEComatous variants and proposed histopathogenesis.". Pathology 39 (2): 235-40. doi:10.1080/00313020701230799. PMID 17454754.