Encyclopedia of Pathology

Living Edition
| Editors: J.H.J.M. van Krieken

Papillary Adenoma

  • Anna Caliò
  • Diego Segala
  • Guido MartignoniEmail author
Living reference work entry
DOI: https://doi.org/10.1007/978-3-319-28845-1_4869-1

Definition

Papillary adenoma is unencapsulated tumor composed of cells with low ISUP/WHO grade arranged in papillary or tubular architecture and 15 mm in diameter or smaller (Umbreit and Thompson 2011). A diagnosis of papillary adenoma on needle biopsy should be made with extreme caution.

Clinical Features

  • Incidence

    In autopsy series, papillary adenomas have been reported in approximately 10% of individuals (Caliò et al. 2019).

  • Age

    The frequency of papillary adenomas increased throughout adulthood.

  • Sex

    Papillary adenomas are roughly five times more frequent in men than in women.

  • Site

    There is no site predilection.

  • Treatment

    Papillary adenoma is a clinically silent and incidental finding; a therapeutic approach is not required.

  • Outcome

    Papillary adenoma is a benign tumor.

Macroscopy

Papillary adenomas arise in the renal cortex and often are subcapsular.

Microscopy

Papillary adenoma shows a papillary, tubular, or tubulopapillary architecture (Fig. 1).
Fig. 1

A subcapsular papillary adenoma showing papillary architecture. Note the absence of pseudocapsule

The cells have predominantly pale and scanty cytoplasm with round nuclei and inconspicuous nucleoli. Foamy macrophages and psammoma bodies may be present.

Immunophenotype

Papillary adenoma expresses CK7 and racemase.

Molecular Features

Papillary adenomas frequently show trisomy 7 and 17 and loss of the Y chromosome (Brunelli et al. 2003).

Differential Diagnosis

The most important differential diagnosis is papillary renal cell carcinoma based on dimension and presence/absence of capsule.

References and Further Reading

  1. Brunelli, M., Eble, J. N., Zhang, S., et al. (2003). Gains of chromosomes 7, 17, 12, 16, and 20 and loss of Y occur early in the evolution of papillary renal cell neoplasia: A fluorescent in situ hybridization study. Modern Pathology, 16, 1053–1059.CrossRefGoogle Scholar
  2. Caliò, A., Warfel, K. A., & Eble, J. N. (2019). Papillary adenomas and other small epithelial tumors in the kidney: An autopsy study. The American Journal of Surgical Pathology, 43(2), 277–287.CrossRefGoogle Scholar
  3. Umbreit, E. C., & Thompson, R. H. (2011). Metastatic potential of the small renal mass: Why can’t we agree? European Urology, 60, 983–985.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Diagnostic and Public Health, Section of PathologyUniversity of VeronaVeronaItaly
  2. 2.Department of PathologyPederzoli Hospital, Peschiera del GardaPeschiera del GardaItaly