Clinicopathologic spectrum of adult nephrectomy specimens – A two year study

Abstract

Nephrectomy is indicated in patients with a wide range of conditions such as irreversibly damaged kidney resulting from symptomatic chronic infections, obstruction, calculi, severe traumatic injury, treatment of renovascular hypertension from non correctable renal artery disease or renal cell carcinoma. To review the clinicopathological spectrum of renal lesions in total or partial nephrectomy specimens in a tertiary care hospital in Mangalore and to study the non neoplastic renal parenchyma in tumor nephrectomy specimens. Materials and MethodsThe present study was done on 52 nephrectomy specimens received at the Department of Pathology, A.J Institute of Medical Sciences & Research Centre, Mangalore during a period of 2 years (May 2014 - May 2016). A total of 52 cases over a period of 2 years were studied out of which 35(67.3%) were neoplastic.34/35 were malignant out of which, 29 were Clear cell Renal Cell Carcinoma (RCC) followed by 2 cases of papillary RCC, 2 cases of sarcomatoid RCC and 1 case of chromophobe RCC. A single case of angiomyolipoma were found. The most common finding in nonneoplastic renal parenchyma immediately adjacent to the tumor was chronic pyelonephritis 57.1% and one case showed caseating tuberculous nephritis. Out of 17 non-neoplastic conditions, 52.9% were hydronephrosis in association with chronic pyelonephritis. Two cases each of adult polycystic kidney disease and caseating tuberculous pyelonephritis were found. Malignant renal tumors are the major indication for nephrectomy and adequate examination of the adjacent non-neoplastic renal parenchyma is an important tool in recognising patients at risk for early patient care. A detailed histological study of benign nephrectomies could be a clinical predictor for further clinical course, as well as a management strategy for slowing down the progression or decline of renal function.