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Difference between revisions of "Nephrogenic adenoma"
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'''Nephrogenic adenoma''', also known as '''mesonephric adenoma''',<ref name=pmid21716880>{{Cite journal | last1 = Singh | first1 = KJ. | title = Mesonephric adenoma in remnant ureteric stump: A rare entity. | journal = Indian J Urol | volume = 27 | issue = 1 | pages = 140-1 | month = Jan | year = 2011 | doi = 10.4103/0970-1591.78414 | PMID = 21716880 }}</ref> and '''nephrogenic metaplasia''', is a rare lesion that is classically in the [[urinary bladder]] and can mimic [[adenocarcinoma]]. | |||
==General== | |||
Features:<ref name=pmid12118115>{{Cite journal | last1 = Gokaslan | first1 = ST. | last2 = Krueger | first2 = JE. | last3 = Albores-Saavedra | first3 = J. | title = Symptomatic nephrogenic metaplasia of ureter: a morphologic and immunohistochemical study of four cases. | journal = Mod Pathol | volume = 15 | issue = 7 | pages = 765-70 | month = Jul | year = 2002 | doi = 10.1097/01.MP.0000019578.51568.24 | PMID = 12118115 | url = http://www.nature.com/modpathol/journal/v15/n7/full/3880603a.html }}</ref> | |||
*Benign. | |||
**May mimic adenocarcinoma! | |||
*Classic location is the [[urinary bladder]]. | |||
**Also reported in ureter and prostatic urethra. | |||
*It is thought to result from displacement of renal tubular cells, as this entity in renal transplant recipients is graft derived.<ref>{{Cite journal | last1 = Mazal | first1 = PR. | last2 = Schaufler | first2 = R. | last3 = Altenhuber-Müller | first3 = R. | last4 = Haitel | first4 = A. | last5 = Watschinger | first5 = B. | last6 = Kratzik | first6 = C. | last7 = Krupitza | first7 = G. | last8 = Regele | first8 = H. | last9 = Meisl | first9 = FT. | title = Derivation of nephrogenic adenomas from renal tubular cells in kidney-transplant recipients. | journal = N Engl J Med | volume = 347 | issue = 9 | pages = 653-9 | month = Aug | year = 2002 | doi = 10.1056/NEJMoa013413 | PMID = 12200552 }}</ref> | |||
==Microscopic== | |||
Features:<ref name=pmid12118115>{{Cite journal | last1 = Gokaslan | first1 = ST. | last2 = Krueger | first2 = JE. | last3 = Albores-Saavedra | first3 = J. | title = Symptomatic nephrogenic metaplasia of ureter: a morphologic and immunohistochemical study of four cases. | journal = Mod Pathol | volume = 15 | issue = 7 | pages = 765-70 | month = Jul | year = 2002 | doi = 10.1097/01.MP.0000019578.51568.24 | PMID = 12118115 | url = http://www.nature.com/modpathol/journal/v15/n7/full/3880603a.html }}</ref> | |||
*Tubular structures - '''key feature'''. | |||
**Hobnailed cells. | |||
**+/-Thick eosinophilic basement membrane. | |||
**Microcystic appearance. | |||
*Usually associated with chronic inflammation. | |||
Notes: | |||
*May mimic vascular/lymphatic channels - can be sorted-out with IHC. | |||
DDx: | |||
*[[Urothelial carcinoma]], microcystic and nested variants. | |||
*[[Prostatic adenocarcinoma]]. | |||
*[[Clear cell adenocarcinoma]]. | |||
===Images=== | |||
<gallery> | |||
Image:Nephrogenic_adenoma_-_intermed_mag.jpg | Nephrogenic adenoma - intermed. mag. (WC/Nephron) | |||
Image:Nephrogenic_adenoma_-_very_high_mag.jpg | Nephrogenic adenoma - very high mag. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://www.archivesofpathology.org/action/showFullPopup?id=i1543-2165-134-10-1455-f01&doi=10.1043%2F2010-0226-CR.1 NA (archivesofpathology.org)].<ref name=pmid20923300>{{Cite journal | last1 = Kunju | first1 = LP. | title = Nephrogenic adenoma: report of a case and review of morphologic mimics. | journal = Arch Pathol Lab Med | volume = 134 | issue = 10 | pages = 1455-9 | month = Oct | year = 2010 | doi = 10.1043/2010-0226-CR.1 | PMID = 20923300 }}</ref> | |||
==IHC== | |||
Features:<ref name=pmid22415059>{{Cite journal | last1 = Alexiev | first1 = BA. | last2 = Levea | first2 = CM. | title = Nephrogenic Adenoma of the Urinary Tract: A Review. | journal = Int J Surg Pathol | volume = | issue = | pages = | month = Mar | year = 2012 | doi = 10.1177/1066896912439095 | PMID = 22415059 }}</ref> | |||
*CK7 +ve. | |||
*PAX2 +ve. | |||
*PAX8 +ve. | |||
*AMACR +ve/-ve. | |||
Others:<ref name=pmid12118115>{{Cite journal | last1 = Gokaslan | first1 = ST. | last2 = Krueger | first2 = JE. | last3 = Albores-Saavedra | first3 = J. | title = Symptomatic nephrogenic metaplasia of ureter: a morphologic and immunohistochemical study of four cases. | journal = Mod Pathol | volume = 15 | issue = 7 | pages = 765-70 | month = Jul | year = 2002 | doi = 10.1097/01.MP.0000019578.51568.24 | PMID = 12118115 }}</ref> | |||
*p53 -ve. | |||
*CEA -ve. | |||
*Ki-67 low (<5%). | |||
==See also== | |||
*[[Urothelium]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Urothelium]] | |||