Metanephric adenoma

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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), renal mucinous tubular and spindle cell carcinoma
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

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: metanephric adenoma is a tumour.

General

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

Gross

  • Sharply circumscribed.
  • Not encapsulated.[2]

Microscopic

Features:[3]

  • 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. Mantoan Padilha, M.; Billis, A.; Allende, D.; Zhou, M.; Magi-Galluzzi, C. (May 2013). "Metanephric adenoma and solid variant of papillary renal cell carcinoma: common and distinctive features.". Histopathology 62 (6): 941-53. doi:10.1111/his.12106. PMID 23551615.
  3. 3.0 3.1 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.
  4. 4.0 4.1 4.2 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.
  5. 5.0 5.1 5.2 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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