Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
2007-1-19
pubmed:abstractText
The precursor lesions of renal cell carcinoma (RCC) are unknown. The purpose of this study is to determine the incidence, histomorphological features, and immunohistochemical features of papillary adenoma and elucidate its potential relationship to RCC. We reviewed 542 consecutive nephrectomy specimens over an 8-year period. Immunohistochemistry was carried out with antibodies specific for alpha-methyl-coenzyme A racemase (AMACR) and glutathione S-transferase alpha (clear-cell RCC marker). Thirty-eight (7%) nephrectomy specimens showed histologic evidence of papillary adenoma. Of these 38 cases, 18 (47%) arose in the setting of papillary RCC (PRCC). Seven papillary adenomas (18%) occurred in the setting of acquired polycystic kidney disease (APKD), 6 in clear-cell RCCs, 3 in chromophobe RCCs, 2 in end-stage kidney disease, 1 in oncocytoma, 1 in angiomyolipoma, and 1 in renal schwannoma. Furthermore, papillary adenomas were more commonly found in kidneys removed for PRCC (25%, 18/71) than in kidneys harboring clear-cell RCC (1.9%, 6/318). Histomorphologically, papillary adenomas were characterized by varying proportions of papillae and tubules formed by cuboidal cells with scant basophilic cytoplasm similar to those in type 1 PRCC. Adenomas associated with PRCC tend to be multiple in number (61% [11/18] of cases had >2 adenomas; mean, 5). In contrast, 100% of papillary adenomas arising in other conditions had less than 2 adenomas. Most of the adenomas (82%, 31/38) stained strongly for AMACR in a fashion similar to that of PRCC. The 7 AMACR-negative cases all arose in the setting of APKD. In this study of surgical specimens, the high coincidence, multifocality, and histologic and immunohistochemical similarities between papillary adenoma and PRCC suggest that the 2 are strongly associated and may represent a continuum of 1 biologic process. In contrast, adenomas associated with APKD exhibit distinct morphological and immunohistochemical features and, therefore, may have an entirely different pathogenesis.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Feb
pubmed:issn
0046-8177
pubmed:author
pubmed:issnType
Print
pubmed:volume
38
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
239-46
pubmed:meshHeading
pubmed-meshheading:17056094-Adenocarcinoma, Clear Cell, pubmed-meshheading:17056094-Adenoma, pubmed-meshheading:17056094-Adenoma, Oxyphilic, pubmed-meshheading:17056094-Adult, pubmed-meshheading:17056094-Aged, pubmed-meshheading:17056094-Aged, 80 and over, pubmed-meshheading:17056094-Angiomyolipoma, pubmed-meshheading:17056094-Carcinoma, Papillary, pubmed-meshheading:17056094-Carcinoma, Renal Cell, pubmed-meshheading:17056094-Disease Progression, pubmed-meshheading:17056094-Female, pubmed-meshheading:17056094-Glutathione Transferase, pubmed-meshheading:17056094-Humans, pubmed-meshheading:17056094-Immunohistochemistry, pubmed-meshheading:17056094-Isoenzymes, pubmed-meshheading:17056094-Kidney, pubmed-meshheading:17056094-Kidney Failure, Chronic, pubmed-meshheading:17056094-Kidney Neoplasms, pubmed-meshheading:17056094-Male, pubmed-meshheading:17056094-Middle Aged, pubmed-meshheading:17056094-Models, Biological, pubmed-meshheading:17056094-Polycystic Kidney Diseases, pubmed-meshheading:17056094-Racemases and Epimerases
pubmed:year
2007
pubmed:articleTitle
Renal papillary adenoma--a putative precursor of papillary renal cell carcinoma.
pubmed:affiliation
Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
pubmed:publicationType
Journal Article