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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Metanephric_adenoma_-_very_high_mag.jpg | |||
| Width = | |||
| Caption = Metanephric adenoma. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = 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]] | |||
| Subtypes = | |||
| LMDDx = [[Wilms tumour]], [[papillary renal cell carcinoma]] (type 1), [[renal mucinous tubular and spindle cell carcinoma]] | |||
| Stains = | |||
| IHC = WT-1 +ve, CD57 +ve, AMACR -ve, CD56 -ve | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[kidney]] - see ''[[kidney tumours]]'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = usu. adults, occasionally children | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = good, benign | |||
| Other = | |||
| ClinDDx = | |||
| Tx = | |||
}} | |||
'''Metanephric adenoma''' is a benign tumour of the kidney. | |||
It should '''not''' be confused ''[[mesonephric adenoma]]'', another term for ''nephrogenic adenoma''. | |||
This can be remembered as follows: ''me'''t'''anephric adenoma is a '''t'''umour''. | |||
==General== | |||
*Benign. | |||
*Afflicts adults and occasionally children. | |||
*May be associated with [[polycythemia]].<ref name=pmid21220212>{{Cite journal | last1 = Le Nué | first1 = R. | last2 = Marcellin | first2 = L. | last3 = Ripepi | first3 = M. | last4 = Henry | first4 = C. | last5 = Kretz | first5 = JM. | last6 = Geiss | first6 = S. | title = Conservative treatment of metanephric adenoma. A case report and review of the literature. | journal = J Pediatr Urol | volume = 7 | issue = 4 | pages = 399-403 | month = Aug | year = 2011 | doi = 10.1016/j.jpurol.2010.09.010 | PMID = 21220212 }}</ref> | |||
==Gross== | |||
*Sharply circumscribed. | |||
*Not encapsulated.<ref name=pmid23551615>{{Cite journal | last1 = Mantoan Padilha | first1 = M. | last2 = Billis | first2 = A. | last3 = Allende | first3 = D. | last4 = Zhou | first4 = M. | last5 = Magi-Galluzzi | first5 = C. | title = Metanephric adenoma and solid variant of papillary renal cell carcinoma: common and distinctive features. | journal = Histopathology | volume = 62 | issue = 6 | pages = 941-53 | month = May | year = 2013 | doi = 10.1111/his.12106 | PMID = 23551615 }}</ref> | |||
==Microscopic== | |||
Features:<ref name=Ref_WMSP284>{{Ref WMSP|284}}</ref> | |||
*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: | |||
*Epithelioid nephroblastoma ([[Wilms tumour]]) - these typically have: | |||
**Irregular nuclear membrane. | |||
**Nucleoli. | |||
**Mitoses (rare in ''metanephric adenoma''). | |||
*[[Papillary renal cell carcinoma|Papillary RCC]].<ref name=Ref_WMSP284>{{Ref WMSP|284}}</ref> | |||
*[[Renal mucinous tubular and spindle cell carcinoma]]. | |||
*Other [[small round cell tumours]], e.g. [[small cell carcinoma]]. | |||
===Images=== | |||
<gallery> | |||
Image:Metanephric_adenoma_high_mag.jpg | Metanephric adenoma. [[PAS stain]]. (WC/Nephron) | |||
Image:Metanephric_adenoma_high_mag_cropped.jpg | Metanephric adenoma - cropped. [[PAS stain]]. (WC/Nephron) | |||
</gallery> | |||
<gallery> | |||
Image:Metanephric_adenoma_-_low_mag.jpg | Metanephric adenoma - PaRCC-like - low mag. (WC/Nephron) | |||
Image:Metanephric_adenoma_-_intermed_mag.jpg | Metanephric adenoma - PaRCC-like - intermed. mag. (WC/Nephron) | |||
Image:Metanephric_adenoma_-_high_mag.jpg | Metanephric adenoma - PaRCC-like - very high mag. (WC/Nephron) | |||
Image:Metanephric_adenoma_-_very_high_mag.jpg | Metanephric adenoma - PaRCC-like - very high mag. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://www.nature.com/modpathol/journal/v16/n10/fig_tab/3880886f1.html Metanephric adenoma (nature.com)]. | |||
==IHC== | |||
*WT-1 +ve.<ref name=pmid24083046>{{Cite journal | last1 = Watanabe | first1 = S. | last2 = Naganuma | first2 = H. | last3 = Shimizu | first3 = M. | last4 = Ota | first4 = S. | last5 = Murata | first5 = S. | last6 = Nihei | first6 = N. | last7 = Matsushima | first7 = J. | last8 = Mikami | first8 = S. | last9 = Kuroda | first9 = N. | title = Adult nephroblastoma with predominant epithelial component: a differential diagnostic candidate of papillary renal cell carcinoma and metanephric adenoma-report of three cases. | journal = Case Rep Pathol | volume = 2013 | issue = | pages = 675875 | month = | year = 2013 | doi = 10.1155/2013/675875 | PMID = 24083046 }}</ref> | |||
*CD57 +ve.<ref name=pmid24083046/> | |||
*AMACR -ve.<ref name=pmid24083046/> | |||
*CD56 -ve.<ref name=pmid11688464/> | |||
**Positive in Wilms tumour<ref name=pmid11688464/> and small cell carcinoma. | |||
*CK7 +ve (focal).<ref name=pmid11688464>{{Cite journal | last1 = Muir | first1 = TE. | last2 = Cheville | first2 = JC. | last3 = Lager | first3 = DJ. | title = Metanephric adenoma, nephrogenic rests, and Wilms' tumor: a histologic and immunophenotypic comparison. | journal = Am J Surg Pathol | volume = 25 | issue = 10 | pages = 1290-6 | month = Oct | year = 2001 | doi = | PMID = 11688464 }}</ref> | |||
*TTF-1 -ve.{{fact}} | |||
==Sign out== | |||
<pre> | |||
Left Kidney, Total Nephrectomy: | |||
- Metanephric adenoma, see comment. | |||
COMMENT: | |||
The tumour stains as follows: | |||
POSITIVE: WT1, CD57, PAX8. | |||
NEGATIVE: CD56, TTF-1, AMACR. | |||
</pre> | |||
==See also== | |||
*[[Kidney tumours]]. | |||
*[[Mesonephric adenoma]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Kidney tumours]]. | |||