Lesions In Nephrectomy Specimens Research Articles

HISTOMORPHOLOGICAL PATTERNS OF VARIOUS KIDNEY LESIONS IN NEPHRECTOMY SPECIMENS: A FIVE YEARS EXPERIENCE IN A TERTIARY CARE HOSPITAL

Background: A variety of non-neoplastic diseases and both benign and malignant neoplasms occur in the kidney. Radiological studies like ultrasound, CT and MRI are useful to provide a preoperative diagnosis, but histopathological study still remains the gold standard for definite diagnosis. This study aimed to explore the histomorphological patterns of various kidney lesions in nephrectomy specimens. Methods: This was a retrospective study conducted in the department of Pathology at College of Medical Sciences, Bharatpur, Chitwan from the period of 1st August 2017 to 31st July 2022. 57 samples of nephrectomy specimens were received during the study period of five years and were included in the study. Results: Maximum number of patients undergoing nephrectomy were in the age group of 40 to 49 years. Non neoplastic lesions constituted 87.72% of the nephrectomy specimens while the remaining were neoplastic cases. Chronic pyelonephritis was the commonest non neoplastic lesion. The commonest neoplastic lesion was renal cell carcinoma followed by transitional cell carcinoma and squamous cell carcinoma. Conclusions: Chronic pyelonephritis is a preventable cause of nephrectomy which could be avoided with early diagnosis and no operative management. The commonest malignant neoplasm was renal cell carcinoma.

Peritumoral Adipose Tissue Density Predicts the Malignancy in cT1 Renal Masses.

Not only the frequency of surgery for small renal masses has increased secondary to the improvements and frequent use of imaging techniques but also the frequency of detection of benign lesions in nephrectomy specimens has increased as well. We aimed to assess the predictive value of computed tomography density of perirenal adipose tissue and peritumoral adipose tissue in distinguishing between benign and malignant renal masses. The current study included 116 patients who underwent nephrectomy for renal masses between January 2015 and December 2020. Clinicodemographic and preoperative computed tomography features and final pathological findings of the patients were recorded. According to the final pathological results, the patients were divided into 2 groups benign (n = 32) and malignant (n = 84). Groups were compared statistically in terms of perirenal adipose tissue and peritumoral adipose tissue density. The median tumor size was 5.00 cm. The rate of benign tumors was higher in female patients (P = .005). The median peritumoral adipose tissue density among cT1 and cT1a tumors was higher in the malignant group (P < .001, for each). At a cutoff value of 97.50 Hounsfield Units, the peritumoral adipose tissue density had a sensitivity of 83.0% and a specificity of 79.2% for predicting the presence of malignant tumors in ≤7 cm renal masses. Using a cutoff value of -97.50 Hounsfield Units, the peritumoral adipose tissue density had a sensitivity of 88.9% and a specificity of 83.3% for predicting the presence of malignant tumors in ≤4 cm renal masses. The peritumoral adipose tissue density in the preoperative computed tomography images predicts the malignancy in cT1 renal masses.

Study of Pattern of Histopathological Lesions in Nephrectomy Specimens in a Tertiary Care Hospital

Study of Pattern of Histopathological Lesions in Nephrectomy Specimens in a Tertiary Care Hospital

Histopathological study of various nephrectomy specimens received at tertiary care hospital: A retrospective study

Introduction: The Kidney is one of the most highly differentiated organs in the body affected by various disease processes, some resulting in permanent damage leading to surgical removal of kidney i.e., nephrectomy. Indications for nephrectomy are varied including irreversible damage by chronic infections, obstructive causes stricture and calculus diseases, vesicouretric reflex, congenital displasia, nephrosclerosis, cystic disease and also severe traumatic injury, non corrective renal artery disease leading to renovascular hypertension. Simple nephrectomy is done to remove the irreversibly damaged, non-functioning kidneys involved by different benign pathologic condition while radical nephrectomy is indicated in malignant lesion.Aim: To assess the patterns and morphology of lesions in nephrectomy specimens in a tertiary care hospital.Material and MethodThis retrospective study carried out in the Department of Pathology in B.J. Medical college and civil Hospital, Ahmedabad, Gujarat, India. A total of 63 nephrectomy specimens received during the period of 1 year and 5 months from January 2021 to may 2022 were included in the study. Paraffin blocks and slides along with case records were retrieved and studied.Results: Patients with a male to female ratio of 1.25:1. Maximum cases of chronic pyelonephritis were seen in the age group of 20-40 years. Among 63 nephrectomy cases, 38 cases were non-neoplastic lesions and 25 of the cases were neoplastic lesions. Among 25 cases of renal cell carcinoma, clear cell renal cell carcinoma (13) cases were the most frequent followed by papillary RCC (4) cases. Conclusion: Nephrectomy is an accepted surgical procedure for non-functioning kidneys due to various pathological disease processes. Most common affected age group was 20-40 years. Non neoplastic lesions were the most common cause for nephrectomies. Chronic pylonephritis with hydronephrotic changes being the most common cause. Clear Cell renal cell carcinoma being the common among malignant tumors. Other benign and malignant lesions being rare.

Histopathological spectrum of lesions in nephrectomy specimens: Five years’ experience in a private lab.

Objective: The aim of this study was to evaluate the histopathological changes in the nephrectomy specimens. Study Design: Retrospective study. Setting: Private Lab, Located in Faisalabad. Period: January 2015 to December 2019. Material &amp; Methods: A total of 113 cases were included in the study. In this study paraffin blocks and previous slides along with clinical data were analyzed according to standard protocols. Patient age, sex and histological diagnosis were noted and compared. Results: In this study we analyzed 113 cases, received during a five year time period. Out of which 60 (53%) were males and 53 (47%) were females. Most common age group ranges from 51 to 60 years and the least common affected group was 71 to 80 years. The neoplastic cases were 66 (58%) and nonneoplastic cases were 47(42%). Neoplastic were further sub- divided in to 3(5%) benign cases and 63(95%) malignant cases. Most common neoplastic lesion was clear cell renal cell carcinoma, 49 (74%) cases and most common non- neoplastic condition was chronic pyelonephritis, 37 (78%) cases. Conclusion: Nephrectomy is the ultimate surgical procedure for the treatment of renal diseases. The 5th to 6th decade is the most common age group of patients affected by non- neoplastic conditions leading to non-functioning kidney. Malignant tumor like clear cell carcinoma is the most common malignant tumor in our society. Early clinical, radiological and histopathological diagnosis of renal diseases will help out patients for proper management. Thus every nephrectomy specimen should be evaluated through clinico –pathological correlation.

Histomorphological Spectrum of Lesions in Nephrectomy Specimen

Background&#x0D; Nephrectomy is a common and standard surgical practice in urology. It has pivotal role in diagnosis, treatment and prognosis of disease. It is indicated in patients with irreversible kidney damage following chronic infection, trauma, obstruction and malformation as well as renal malignancy. The objective of this study was to analyze the histomorphological spectrum of various lesions in nephrectomy specimens with special emphasis on grading and staging of renal carcinoma.&#x0D; Methods&#x0D; This is a retrospective study done from January 2015 to December 2020 in the Department of Pathology, Dhulikhel Hospital - Kathmandu University Hospital (DH - KUH). Relevant clinical data of the patients were obtained from the histopathological records of the patient from the pathology department.&#x0D; Results&#x0D; A total of 70 cases were studied, out of which 60 were simple nephrectomy specimens, followed by 8 radical and 2 partial nephrectomy specimens. The age of patient ranged from 2 to 74 years. Highest percentage of nephrectomy was seen in 4th decade of life. Male population comprising 54.28% of nephrectomy. Non-neoplastic lesions constituted 53 cases and chronic pyelonephritis was the most common lesion. Out of 17 neoplastic lesions, 76.47% of cases were malignant. Clear cell renal cell carcinoma was the most common malignant tumour.&#x0D; Conclusions&#x0D; This study gives a fair insight into the incidence of neoplastic and non-neoplastic lesions of kidney requiring nephrectomy in this institution.

Observational Histopathological Analysis of Renal Lesions in Nephrectomy Specimens

Aim: This observational retrospective study was initiated to perform histopathological spectrum analysis of renal lesions from resected nephrectomy specimens. Materials and Methods: This was a retrospective observational study. Over a span of 4 years a total of 62 nephrectomy cases who underwent nephrectomy in a tertiary health care center and specimens were received from the surgical Department of the Hospital were analysed. Microscopic and gross features of the specimen were studied. Result: 12(19%) nephrectomy specimens out of 62 were malignant and 50 (81%) were benign. The mean age of patients from whom specimen were collected was 44.16 ± 29.8 years. 34 (54.9%) were Chronic Pyelonephritis cases, some associated with hydronephrosis and others with calculi. Out of 12 total malignant lesions 8 cases (12.9%) constituted as renal cell carcinoma. Among children commonest malignant tumour was Wilm’s tumour. Among the clinical presentation most common was flank pain in 17 (53.1%) cases followed by fever and burning micturition. Conclusion: In current study as compared to the benign tumours, malignant renal tumours far outnumbered. In paediatric age group most common malignancy was the Wilms tumour. Most common histomorphological diagnosis was Chronic Pyelonephritis and among the malignant lesions commonest were Renal Cell Carcinoma. Keywords: Nephrectomy, Histopathology, Chronic Pyelonephritis, Wilm’s tumour, Renal Cell Carcinoma.

English

BACKGROUND Nephrectomy is the standard surgical treatment of neoplastic and non-neoplastic lesions in the kidney and provides more insight into the detailed histopathology of renal lesions. We wanted to identify the age groups, gender distribution and different histopathological types and subtypes of non-neoplastic and neoplastic lesions in nephrectomy specimens over a period of ten years. METHODS A retrospective analysis was done over a period of ten years (January 2006 to December 2015). All nephrectomy specimens received in the Department of Pathology, Government Medical College, Kottayam were recorded from histopathology registers and analysed with regard to age, gender and histopathological types. RESULTS A total of 532 lesions was encountered in our analysis. Males (61.8 %) were affected more than females (38.2 %). Lesions were more on the left side (50.8 %) than right side (49.2 %). Non-neoplastic lesions (53 %) outnumbered neoplastic lesions (47 %). Inflammatory and obstructive causes constituted the majority (43.8 %) in non-neoplastic lesions and renal cell carcinoma was the commonest neoplasm (71.2 %). CONCLUSIONS There is a wide age distribution of renal diseases in the present study. Inflammatory and obstructive conditions constituted the most common indication for nephrectomy, followed by malignant tumours. KEYWORDS Renal Cell Carcinoma, Nephrectomy, Pyelonephritis, Simple Renal Cyst, Wilms Tumour

Histopathological Spectrum of Lesions in Nephrectomy Specimens in a Tertiary Care Hospital

Histopathological Spectrum of Lesions in Nephrectomy Specimens in a Tertiary Care Hospital

Histopathological spectrum of lesions in Nephrectomy specimens in a tertiary care hospital in North India

Histopathological spectrum of lesions in Nephrectomy specimens in a tertiary care hospital in North India

Prevalence of pathological lesions in 161 nephrectomies: An experience from a teaching hospital in urban industrial area of Maharashtra

Background: Kidneys can be involved in various pathological processes. Nephrectomy is a common procedure in urological practice. Aim: The objective of the present study is to find out the frequency of various neoplastic and non-neoplastic lesions in nephrectomy specimens and to study histomorphological features from a teaching hospital in urban industrial area. Materials and Methods: The study included 161 nephrectomy specimens. Grossly, findings were noted. Detailed histological features were studied. Lesions were broadly categorized into non-neoplastic and neoplastic. Nuclear Grading System was used to grade clear-cell renal cell carcinoma (RCC) and papillary RCC. The International Society of Pediatric Oncology staging was used to stage Wilms', tumors. The staging of RCC was done by tumor, node, and metastasis classification as per the World Health Organization 2016. Other clinical details were correlated with histomorphological features. Results: Of 161 nephrectomy specimens, 81 (50.31%) were males and 80 (49.68%) were females. The mean age was 45.43 (±19.43 standard deviation) years. 115 (71.42%) nephrectomy specimens showed -non-neoplastic lesions and 46 (28.57%) showed neoplastic lesions. The most common non-neoplastic lesions were chronic pyelonephritis in 106 (92.17%) patients. RCC (n = 36) was the most common neoplastic lesion. Conclusion: In developing countries like India, chronic pyelonephritis remains the most common cause of nephrectomy. Nephrectomy due to non-neoplastic lesions is more common in younger age group as compared to neoplastic lesions. Early diagnosis and better treatment modalities for inflammatory lesions of the kidney in the developing countries will reduce the rate of nephrectomies.

Spectrum of pathological lesions in nephrectomy specimens: A study of 50 lesions

Introduction: Kidneys are involved in variety of pathological processes. Renal diseases are an important cause of morbidity worldwide. Chronic pyelonephritis and its variants still continue to be the leading cause of nephrectomies in developing country like India. In some developed countries, neoplastic lesion is the commonest indication for nephrectomy. Aim: The study is carried out to study the frequency of various neoplastic and non-neoplastic lesions in nephrectomy specimens and to study histomorphological features in a teaching hospital. Materials and Methods: The t otal of 50 nephrectomy cases were studied. Detailed clinical finding were collected from case sheets. Detailed gross findings and histomorphological features were studied. Results: Out of 50 lesions 35 were non neoplastic and 15 were neoplastic. Out of 35 nephrectomy lesions, 32 cases were of chronic pyelonephritis and males (n=18) were commonly affected than female (n=14). Out of 15 neoplastic lesions majority(n=12) were renal cell carcinoma and most commonly (n=12) involved males. Conclusion: In developing country like India pyelonephritis is the commonest cause of nephrectomy. Better treatment modalities of inflammatory lesions of kidney in the develop ing countries will reduce the rate of nephrectomies. Keywords: Kidney, Carcinoma, Chronic, Pyelonephritis.

A Histopathological study of Malignant Lesions in Nephrectomy Specimens: A Two Year Study

A Histopathological study of Malignant Lesions in Nephrectomy Specimens: A Two Year Study

Non- Neoplastic Lesions in Nephrectomy Specimens: A Histopathological Study

Non- Neoplastic Lesions in Nephrectomy Specimens: A Histopathological Study

Histomorphological Analysis of Lesions In Nephrectomy Specimens: A 4 Years Study In A Rural Hospital In India- Our Experience.

Background - Kidney is involved in various pathological conditions ranging from non-neoplastic lesions to neoplastic diseases like renal cell carcinoma. Nephrectomy remains the treatment of choice for patient care in end stage renal diseases from various causes and neoplastic lesions. Objective: To study the histomorphological spectrum and frequency of various lesions in nephrectomy specimens. Material and methods:- A observational retrospective research study included 33 nephrectomy specimens in the department of pathology over a period of 4 years (April 2012 to April 2016).Clinical details and radiological findings were noted from records and clinico-histomorphological correlation was done. Results: - A total of 33 nephrectomy specimens were studied. Age distribution varied from 16 to 71 years with male to female ratio of 2:1.Benign lesions comprised of maximum cases (75.76%) while malignant lesion were present in 24.24% cases. Chronic nonspecific pyelonephritis was the predominant non-neoplastic finding followed by xanthogranulomatous pyelonephritis. Renal cell carcinoma was the most common malignant lesion in this study. Conclusion: Chronic nonspecific pyelonephritis leading to end stage renal disease is the commonest causative factor in our region ; may be due to consumption of hard water in rural areas. DOI: 10.21276/APALM.1111

English

English

Histopathological spectrum of lesions in nephrectomy specimens: A five-year experience in a tertiary care hospital

Context: Nephrectomy is a common procedure in surgical practice. It is indicated in patients presenting with a wide range of clinical conditions ranging from symptomatic chronic infections, obstruction, calculus disease, and severe traumatic injury to renal cell carcinomas. It is performed increasingly in the context of end-stage renal disease and to treat renovascular hypertension from non-correctable renal artery disease, or for severe unilateral parenchymal damage resulting from nephrosclerosis, pyelonephritis, vesicoureteric reflux, and congenital dysplasia. Objective: This study aimed to assess the patterns and morphology of lesions in nephrectomy specimens in a tertiary care hospital, observe variations if any from the conventional pattern, and clinico-morphological correlation for proper postoperative management. Materials and Methods: A hospital-based five-year study included all nephrectomy specimens received in the department over a period of five years (November 1, 2005 to October 31, 2010). Results: A total of 140 cases over a period of five years were studied. A wide range of lesions were found on histopathological examination. The histopathological analysis correlated well with the clinical diagnosis; however, few benign lesions like xanthogranulomatous pyelonephritis may be misdiagnosed clinically as malignant. Similarly, cases of cystic diseases of kidney, renal sarcomas, renal squamous cell carcinomas, and angiomyolipomas were confirmed on histopathological analysis only. Conclusions: The present study provides a fair insight into the histological patterns of lesions in nephrectomy specimens at our institution. In conclusion, a wide range of lesions are encountered on histopathology of nephrectomy specimens, many of which may be misdiagnosed clinically and radiologically; therefore, it is mandatory that every nephrectomy specimen be subjected to detailed histopathological examination for a clinico-morphological correlation to ensure proper management.

Diagnosing nonneoplastic lesions in nephrectomy specimens.

Abstract Context.—Nonneoplastic changes are often identified in nephrectomy specimens removed for renal neoplasms. Although they may be of prognostic or therapeutic importance, they are often overl...

Diagnosing Nonneoplastic Lesions in Nephrectomy Specimens

Nonneoplastic changes are often identified in nephrectomy specimens removed for renal neoplasms. Although they may be of prognostic or therapeutic importance, they are often overlooked. Nephrectomy is also performed for nonneoplastic lesions, the most frequent of which are urinary obstruction and end-stage renal disease, but the tissue diagnosis of these conditions and the implicated clinicopathologic correlation may not be well appreciated. To outline these nonneoplastic lesions with special attention to important diagnostic caveats and clinicopathologic correlations. The presented information was derived from literature, personal experience, and review of case materials at the authors' institutions. Nonneoplastic lesions are seen in most (90%) nephrectomy specimens removed for renal neoplasms. Although these lesions span the spectrum of "medical" kidney diseases, the most frequent of them are hypertensive nephrosclerosis and diabetic nephropathy. Recognition of these diseases is important because they are often first diagnosed and later confirmed clinically. Furthermore, the severity of these lesions may predicate both short- and long-term renal function and thus help guide treatment. Among conditions that necessitate nephrectomy, advanced urinary obstruction, end-stage renal disease, and end-stage renal disease with acquired cystic changes are probably the most frequent. These conditions have characteristic morphologic features, but they may be associated with superimposing lesions previously not well described. These superimposing lesions may create diagnostic confusion; yet, some of them are the reason for nephrectomy. Thus, acute bacterial infection, urine polyp, granulomatous pyelitis, papillary necrosis, massive bleeding, and renal dysplasia can develop against the background of obstructive nephropathy. Renal neoplasms may develop from the background of end-stage renal disease without cystic changes. A renal neoplasm or massive bleeding with or without neoplasm is usually the reason for nephrectomy in kidney with acquired cystic kidney diseases. Thus, while nonneoplastic changes are frequent in nephrectomy specimens, they are often unrecognized. Awareness of these conditions and a familiarity with their diagnostic features as well as the implicated clinicopathologic correlation should help obviate this diagnostic problem.