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Nonneoplastic Changes in Nephrectomy Specimens for Tumors

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Abstract

Nonneoplastic renal changes are frequent in nephrectomy specimens for tumor. These changes display a wide morphologic and diagnostic range. They often carry profound clinical implications, but are often underappreciated or even ignored. The renal tissue is normal in about 10% of cases. Among the remainders, arterionephosclerosis and diabetic nephropathy account for the majority. These two diseases also account for most of the clinical significance of the nonneoplastic renal changes and their severity correlates with the renal outcome. A large number of other “medical” renal diseases are also encountered, albeit much less frequently. Their morphology is similar to that of their sporadic counterparts, and perhaps so is their clinical behavior. Large renal cell neoplasms, especially those which are centered in renal medulla or urothelial carcinoma, may be associated with changes in nonneoplastic renal parenchyma due to urine obstruction. Kidneys with end-stage renal disease (ESRD) can give rise to renal cell carcinoma directly, or through an intermediate phase characterized by cystic tubular changes aptly termed acquired cystic kidney disease (ACKD). Thus, ESRD alone or with ACKD is increasingly recognized in nephrectomy specimens for renal tumors. Renal tumors of specific histologic types can be a component of several hereditary syndromes. Several distinctive lesions can develop in the nonneoplastic renal tissue in this context. This chapter details these above changes.

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References

  1. Huang WC, Levey AS, Serio AM, et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumors: a retrospective cohort study. Lancet Oncol. 2006;7:735–40.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Bijol V, Mendez GP, Hurwitz S, et al. Evaluation of the nonneoplastic pathology in tumor nephrectomy specimens: predicting the risk of progressive renal failure. Am J Surg Pathol. 2006;30:575–84.

    Article  PubMed  Google Scholar 

  3. Henriksen KJ, Meehan SM, Chang A. Non-neoplastic renal diseases are often unrecognized in adult tumor nephrectomy specimens: a review of 246 cases. Am J Surg Pathol. 2007;31:1703–8.

    Article  PubMed  Google Scholar 

  4. Salvatore SP, Cha EK, Rosoff JS, Seshan SV. Nonneoplastic renal cortical scarring at tumor nephrectomy predicts decline in kidney function. Arch Pathol Lab Med. 2013;137:531–40.

    Article  CAS  PubMed  Google Scholar 

  5. Ito K, Nakashima J, Hanawa Y, et al. The prediction of renal function 6 years after unilateral nephrectomy using preoperative risk factors. J Urol. 2004;171:120–5.

    Article  PubMed  Google Scholar 

  6. McKiernan J, Simmons R, Katz J, et al. Natural history of chronic renal insufficiency after partial and radical nephrectomy. Urology. 2002;59:816–20.

    Article  PubMed  Google Scholar 

  7. Ohishi A, Suzuki H, Nakamoto H, et al. Status patients who underwent uninephrectomy in adulthood more than 20 years ago. Am J Kidney Dis. 1995;26:889–97.

    Article  CAS  PubMed  Google Scholar 

  8. Shirasaki Y, Tsushima T, Nasu Y, et al. Long-term consequence of renal function following nephrectomy for renal cell cancer. Int J Urol. 2004;11:704–8.

    Article  PubMed  Google Scholar 

  9. Leppert JT, Lamberts RW, Thomas IC, Chung BI, Sonn GA, Skinner EC, Wagner TH, Chertow GM, Brooks JD. Incident CKD after radical or partial nephrectomy. J Am Soc Nephrol. 2018;29:207–16.

    Article  PubMed  Google Scholar 

  10. Bonsib SM, Pey Y. The non-neoplastic kidney in tumor nephrectomy specimens. What can it show and what is important. Adv Anat Pathol. 2010;17:235–50.

    Article  PubMed  Google Scholar 

  11. Budin RE, McDonnell PJ. Renal cell neoplasms: their relationship to arteriolonephrosclerosis. Arch Pathol Lab Med. 1984;108:138–41.

    CAS  PubMed  Google Scholar 

  12. Epstein M. Aging and the kidney. J Am Soc Nephrol. 1996;7:1106–22.

    CAS  PubMed  Google Scholar 

  13. Algaba F, Delahunt B, Berney DM, et al. Handling and reporting of nephrectomy specimens for adult renal tumours: a survey by the European Network of Uropathology. J Clin Pathol. 2012;65:106–13.

    Article  PubMed  Google Scholar 

  14. Srigley JR, Amin MB, Delahunt B, et al. Protocol for the examination of specimens from patients with invasive carcinoma of renal tubular origin. Arch Pathol Lab Med. 2010;134:e25–30.

    PubMed  Google Scholar 

  15. Campbell S, Uzzo RG, Allaf ME, Bass EB, Cadeddu JA, Chang A, Clark PE, Davis BJ, Derweesh IH, Giambarresi L, Gervais DA, Hu SL, Lane BR, Leibovich BC, Pierorazio PM. Renal mass and localized renal cancer: AUA guideline. J Urol. 2017;198:520–9.

    Article  PubMed  Google Scholar 

  16. Nasr SH, Galgano SJ, Markowitz GS, et al. Immunofluorescence on pronase-digested paraffin sections: a valuable salvage technique for renal biopsies. Kidney Int. 2006;70:2148–51.

    Article  CAS  PubMed  Google Scholar 

  17. Kuhn E, Anda JD, Manoni S, Netto G, Rosai J. Renal cell carcinoma associated with prominent angioleiomyoma-like proliferation. Report of 5 cases and review of the literature. Am J Surg Pathol. 2006;30:1372–81.

    Article  PubMed  Google Scholar 

  18. Kompotiatis P, Thongprayoon C, Manohar S, Cheungpasitporn W, Gonzalez Suarez ML, Craici IM, Mao MA, Herrmann SM. Association between urologic malignancies and end-stage renal disease: a meta-analysis. Nephrology. 2019;24(1):65–73.

    Article  PubMed  Google Scholar 

  19. Amin MB, Merino MJ. Renal medullary carcinoma. In: Moch H, Humphrey PA, Ulbright TM, Reuter VE, editors. WHO classification of tumours of the urinary system and male genital organs. 4th ed. Lyon: International Agency for Research on Cancer (IARC); 2016. p. 31.

    Google Scholar 

  20. Bacchetta J, Juillard L, Cochat P, Droz J-P. Paraneoplastic glomerular diseases and malignancies. Crit Rev Oncol Hematol. 2009;70:39–58.

    Article  PubMed  Google Scholar 

  21. Nasr SH, Dogan A, Larsen CP. Leukocyte cell-derived chemotaxin 2-associated amyloidosis: a recently recognized disease with distinct clinicopathologic characteristics. Clin J Am Soc Nephrol. 2015;10:2084–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Weis M, Liapiz H, Tomaszewski JE, et al. Pyelonephritis and other infection, reflux nephropathy, hydronephrosis, and nephrolithiasis. In: Jennette JC, Olson JL, Schwartz MM, Silva FG, editors. Heptinstall’s pathology of the kidney. 6th ed. Philadelphia: Lippincott, Williams & Wilkins; 2007. p. 992–1065.

    Google Scholar 

  23. Pais VM, Strandhoy JW, Assimos DG. Pathophysiology of urinary tract obstruction. In: Walsh PC, Retik AB, Vaughan ED, Wein AJ, Kavoussi LR, Partin AW, Peters CA, editors. Campbell’s urology. 4th ed. Philadelphia: Elsevier; 2007. p. 1195–226.

    Google Scholar 

  24. Solez K, Heptinstall RH. Intrarenal urinary extravasation with formation of venous polyps containing Tamm-Horsfall protein. J Urol. 1978;119:180–3.

    Article  CAS  PubMed  Google Scholar 

  25. Bhagavan BS, Wenk RE, Dutta D. Pathways of urinary backflow in obstructive uropathy. Demonstration by pigmented gelatin injection and Tamm-Horsfall uromucoprotein markers. Hum Pathol. 1979;10:669–83.

    Article  CAS  PubMed  Google Scholar 

  26. Gonlusen G, Truong A, Shen SS, et al. Granulomatous pyelitis associated with urinary obstruction: a comprehensive clinicopathologic study. Mod Pathol. 2006;19:1130–8.

    Article  PubMed  Google Scholar 

  27. Truong LD, Choi Y-J, Shen SS, et al. Renal cystic neoplasms and renal neoplasms associated with cystic renal diseases: pathogenetic and molecular links. Adv Anat Pathol. 2003;10:135–59.

    Article  CAS  PubMed  Google Scholar 

  28. Matson M, Cohen E. Acquired cystic kidney disease: occurrence, prevalence, and renal cancers. Medicine. 1990;69:217–42.

    Article  CAS  PubMed  Google Scholar 

  29. Truong L, Krishnan B, Cao J, et al. Renal neoplasm in acquired cystic kidney disease. Am J Kidney Dis. 1995;26:1–12.

    Article  CAS  PubMed  Google Scholar 

  30. Tickoo SK, dePeralta-Venturina MN, Harik LR, et al. Spectrum of epithelial neoplasms in end-stage renal disease: an experience from 66 tumor-bearing kidneys with emphasis on histologic patterns distinct from those in sporadic adult renal neoplasia. Am J Surg Pathol. 2006;30:141–53.

    Article  PubMed  Google Scholar 

  31. Ishikawa I. Hemorrhage versus cancer in acquired cystic disease. Semin Dial. 2000;13:56–64.

    Article  CAS  PubMed  Google Scholar 

  32. Sule N, Yakupoglu U, Shen SS, et al. Calcium oxalate deposition in renal cell carcinoma associated with acquired cystic kidney disease: a comprehensive study. Am J Surg Pathol. 2005;29:443–51.

    Article  PubMed  Google Scholar 

  33. Hughson MD. End-stage renal disease. In: Jennette JC, Olsen JL, Schwartz MM, Silva FG, editors. Heptinstall’s pathology of the kidney. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 1308–37.

    Google Scholar 

  34. Neureiter D, Frank H, Kunzendorf U, et al. Dialysis-associated acquired cystic kidney disease imitating autosomal dominant polycystic kidney disease in a patient receiving long-term peritoneal dialysis. Nephrol Dial Transplant. 2002;17:500–3.

    Article  PubMed  Google Scholar 

  35. Ishikawa I. Uremic acquired renal cystic disease. Nephron. 1991;58:257–67.

    Article  CAS  PubMed  Google Scholar 

  36. Levine E. Acquired cystic kidney disease. Radiol Clin North Am. 1996;34:947–52.

    CAS  PubMed  Google Scholar 

  37. Granthem J. Acquired cystic kidney disease. Kidney Int. 1991;40:143–52.

    Article  Google Scholar 

  38. Moore AE, Kujubu DA. Spontaneous retroperitoneal hemorrhage due to acquired cystic kidney disease. Hemodial Int. 2007;11:S38–40.

    Article  PubMed  Google Scholar 

  39. Schwarz A, Vatandaslar S, Merkel S, et al. Renal cell carcinoma in transplant recipients with acquired cystic kidney disease. Clin J Am Soc Nephrol. 2007;2:750–6.

    Article  PubMed  Google Scholar 

  40. Walther MM, Lubensky IA, Venzon D, Zbar B, Linehan WM. Prevalence of microscopic lesions in grossly normal renal parenchyma from patients with von Hippel-Lindau disease, sporadic renal cell carcinoma and no renal disease: clinical implications. J Urol. 1995;154:2010–4.

    Article  CAS  PubMed  Google Scholar 

  41. Verine J, Pluvinage A, Bousquet G, Lehmann-Che J, de Bazelaire C, Soufir N, Mongiat-Artus P. Hereditary renal cancer syndromes: an update of a systematic review. Eur Urol. 2010;58:701–10.

    Article  PubMed  Google Scholar 

  42. Petersson F, Gatalica Z, Grossmann P, Perez Montiel MD, Alvarado Cabrero I, Bulimbasic S, Swatek A, Straka L, Tichy T, Hora M, Kuroda N, Legendre B, Michal M, Hes O. Sporadic hybrid oncocytic/chromophobe tumor of the kidney: a clinicopathologic, histomorphologic, immunohistochemical, ultrastructural, and molecular cytogenetic study of 14 cases. Virchows Arch. 2010;456:355–65.

    Article  PubMed  Google Scholar 

  43. Pavlovich CP, Grubb RL 3rd, Hurley K, Glenn GM, Toro J, Schmidt LS, Torres-Cabala C, Merino MJ, Zbar B, Choyke P, Walther MM, Linehan WM. Evaluation and management of renal tumors in the Birt-Hogg-Dubé syndrome. J Urol. 2005;173:1482–6.

    Article  PubMed  Google Scholar 

  44. Udager AM, Alva A, Chen YB, Siddiqui J, Lagstein A, Tickoo SK, Reuter VE, Chinnaiyian AM, Mehra R. Hereditary leiomyomatosis and renal cell carcinoma (HLRCC): a rapid autopsy report of metastatic renal cell carcinoma. Am J Surg Pathol. 2014;38:567–77.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Neumann HP, Schwarzkopf G, Henske EP. Renal angiomyolipomas, cysts, and cancer in tuberous sclerosis complex. Semin Pediatr Neurol. 1998;5:269–75.

    Article  CAS  PubMed  Google Scholar 

  46. Yang P, Cornejo KM, Sadow PM, Cheng L, Wang M, Xiao Y, Jiang Z, Oliva E, Jozwiak S, Nussbaum RL, Feldman AS, Paul E, Thiele EA, Yu JJ, Henske EP, Kwiatkowski DJ, Young RH, Wu CL. Renal cell carcinoma in tuberous sclerosis complex. Am J Surg Pathol. 2014;38:895–909.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Aydin H, Magi-Galluzzi C, Lane BR, Sercia L, Lopez JI, Rini BI, Zhou M. Renal angiomyolipoma: clinicopathologic study of 194 cases with emphasis on the epithelioid histology and tuberous sclerosis association. Am J Surg Pathol. 2009;33:289–97.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Ngoentra Tantranont & Boonyarit Cheunsuchon

  2. Departments of Pathology and Genomic Medicine, The Houston Methodist Hospital, Weill-Cornell Medical College, Houston, TX, USA

    Lillian W. Gaber

  3. Department of Pathology and Genomic Medicine, The Houston Methodist Hospital, Houston, TX, USA

    Luan D. Truong

  4. Department of Pathology and Laboratory Medicine, Weill Cornell Medical College of Cornell University, New York, NY, USA

    Luan D. Truong

  5. Department of Pathology and Medicine, Baylor College of Medicine, Houston, TX, USA

    Luan D. Truong

Authors
  1. Ngoentra Tantranont
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  2. Boonyarit Cheunsuchon
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  3. Lillian W. Gaber
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  4. Luan D. Truong
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Correspondence to Luan D. Truong .

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Editors and Affiliations

  1. Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Medical College of Cornell University, Houston, TX, USA

    Mukul K. Divatia

  2. Gulhane Military Medical Academy, School of Medicine, Department of Pathology, Ankara, Turkey

    Ayhan Ozcan

  3. Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Charles C. Guo

  4. Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Medical College of Cornell University, Houston, TX, USA

    Jae Y. Ro

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Tantranont, N., Cheunsuchon, B., Gaber, L.W., Truong, L.D. (2020). Nonneoplastic Changes in Nephrectomy Specimens for Tumors. In: Divatia, M., Ozcan, A., Guo, C., Ro, J. (eds) Kidney Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-28333-9_14

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  • DOI: https://doi.org/10.1007/978-3-030-28333-9_14

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