Renal leiomyoma

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Renal leiomyoma, also leiomyoma of the kidney, is a very rare benign kidney tumour.

General

  • Rare - estimated to represent 0.3% of treated renal tumours.[1]

Microscopic

Features:

  • Fasicular architecture.
  • Spindle cells without significant atypia.

DDx:

IHC

Features:[3]

  • HMB-45 -ve.
  • Desmin +ve.
  • ER and PR +ve (6 of 9 cases:[3]).

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Mass Lesion, Right Kidney, Core Biopsy:
- Benign leiomyoma with hyalinization and without atypia, see comment.
- Renal parenchyma within normal limits present.
- NEGATIVE for malignancy.

Comment:
The tumour stains as follows:
POSITIVE: desmin, SMA, ER, PR.
NEGATIVE: HMB-45.
Proliferation (Ki-67): 0%.

The tumour histology and immunoprofile is that of a leiomyoma. Renal leiomyomas are very rare lesions; a large contemporary series has only 9 cases. [1] 

Correlation with radiology is suggested.

1. Am J Surg Pathol. 2015 Mar;39(3):349-56.

Micro

The sections show tumour with a fascicular architecture and hyalinization. No adipose tissue is seen. Necrosis is not identified. Nuclear atypia is not seen. Mitotic activity is not readily apparent. Benign unremarkable renal parenchyma is present.

See also

References

  1. Khetrapal, S.; Bhargava, A.; Jetley, S.; Rana, S.; Jairajpuri, Z. (Oct 2014). "Renal leiomyoma: an uncommon differential diagnosis of renal masses with a clinical relevance.". J Clin Diagn Res 8 (10): FD08-9. doi:10.7860/JCDR/2014/9434.4993. PMID 25478354.
  2. Fu, L.; Humphrey, PA.; Adeniran, AJ. (Dec 2014). "Renal Leiomyoma.". J Urol. doi:10.1016/j.juro.2014.12.083. PMID 25526990.
  3. 3.0 3.1 Patil, PA.; McKenney, JK.; Trpkov, K.; Hes, O.; Montironi, R.; Scarpelli, M.; Nesi, G.; Aron, M. et al. (Dec 2014). "Renal Leiomyoma: A Contemporary Multi-institution Study of an Infrequent and Frequently Misclassified Neoplasm.". Am J Surg Pathol. doi:10.1097/PAS.0000000000000354. PMID 25517956.