Histopathological Evaluation of Surgically Treated Renal Lesions
Abstract
Background: Nephrectomy is a common procedure in surgical practice. It is indicated in patients presenting with symptomatic chronic infections, obstruction, calculus disease, and severe traumatic injury to renal cell carcinomas. Methods: The present study was conducted in the Department of Pathology and included all nephrectomy specimens received in the department over a period of five years (January 2011 - December 2015). Patient particulars were recorded, which included age, sex, chief complain and clinical findings; investigations such as CT scan, USG, and other relevant investigations were also noted. Meticulous histopathological examination was done and diagnosis was given. Result: Total 124 patients underwent nephrectomy for various renal lesions in the last 5 years. There were 93 (75%) male and 31 (25%) female patients. In 12 patients, tumor was diagnosed on routine abdominal ultrasonographic screening for some other complains. Flank pain was the most common presenting symptom observed in 76 (61.29%) patients, followed by hematuria in 22 (17.54%) patients. On histopathological examination, 94 (75.80%) were non-neoplastic renal lesions and 30 (15.20%) were tumors. In non-neoplastic lesions of total nephrectomy specimens chronic pyelonephritis 70 (56.46%) was the most common type of lesions followed by pyonephrosis 9 (7.26%). There was also presence 4 (3.23%) of cases of Tuberculosis kidney. Overall, RCC was the most common 20 (16.13%) renal tumor. Conclusion: The present study provides a fair insight into the histological patterns of lesions in nephrectomy specimens in our institution and its correlation with studies conducted across the world.References
Algaba F, Trias I, Scarpelli M, Boccon-Gibod L, Kirkali Z, Poppel HV. Handling and pathology reporting of renal tumor specimens. Eur Urol., 2004; 45: 437-43.
Fleming S, Griffiths DFR. Best practice No 180. Nephrectomy for renal tumour: dissection guide and dataset. J Clin Pathol., 2005; 58: 7-14.
Rosai J. Guidelines for handling of most common and important surgical specimens. In: Rosai J, ed. Rosai and Ackerman's Surgical Pathology. 9th edition, St Louis: Mosby, 2004; p. 2911-77.
Furge KA, Lucas KA, Takahashi M, Sugimura J, Kort EJ, Kanayama H, et al. Robust classification of renal cell carcinoma based on gene expression data and predicated cytogenetic profiles. Cancer Res., 2004; 64: 4117-21.
Srigley JR, Hutter RVP, Gelb AB, Henson DE, Kenney G, King BF, et al. Current prognostic factors- renal cell carcinoma. Cancer, 1999; 80: 994-6.
Leibovich BC, Pantuck AJ, Bui MH, Ryu-Han K, Zisman A, Figlin R, et al. Current staging of renal cell carcinoma. Urol Clin North Am., 2003; 30: 481-97.
Moch H, Gasser T, Amin MB, Torhorst J, Sauter G, Mihatsch MJ. Prognostic utility of the recently recommended histologic classification and revised TNM staging system of renal cell carcinoma: a Swiss experience with 588 tumours. Cancer, 2000; 89: 604-14.
Amanullah, Saleem MA, Khan I, Qadri MW, Khan FA. Incidental Detection of Renal Cell Carcinoma. Ann King Edward Med Uni., 1999; 5: 196-8.
Siyal AR, Balouch QD, Shaikh SM, Surahio AW. Renal cell carcinoma. J Surg Pak., 2000; 5: 36-8.
Eble JN, Sauter G, Epstein JI, Sesterhenn IA, eds. Pathology and genetics of tumours of the urinary system and male genital organs. Lyon, France: IARC Press; 2004.
Fuhrman SA, Lasky LC, Limas C. Prognostic significance of morphologic parameters in renal cell carcinoma. Am J Surg Pathol., 1982; 6: 655-63.
Rafique M. Nephrectomy: Indications, complications and mortality in 154 consecutive patients. J Pak Med Assoc., 2007; 57: 308-11.
El Malik EM, Memon SR, Ibrahim AL, Al Gizawi A, Ghali AM. Nephrectomy in Adults: Asir Hospital Experience. Saudi J Kidney Dis Transpl., 1997; 8: 423-7.
Popat VC, Kumar MP, Udani D, Mundra MP, Vora DN, Porecha MM. A study on culprit factors ultimately demanding nephrectomy. Internet J Urol., 2010; 7.
Ghalayini IF. Pathological spectrum of nephrectomies in a general hospital. Asian J Surg., 2002; 25: 163-9.
D’Costa GF, Nagle SB, Wagholikar UL, Nathani RR. Xanthogranulomatous pyelonephritis in children and adults - An 8 year study. Indian J Pathol Microbiol., 1990; 33: 224-9.
Parsons MA, Harris SC, Longstaff AJ, Grainger RG. Xanthogranulomatous pyelonephritis: A pathological, clinical and aetiological analysis of 87 cases. Diagn Histopathol., 1983; 6: 203-19.
Koh KB. Xanthogranulomatous Pyelonephritis in a Malaysian population. Singapore Med J., 1993; 34: 341-2.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
