md-medicaldata

Authors

 

Zoran Milić¹, Aleksandra Ilić^1,2, Katarina Malešević ^1,3, Željka Panić¹, Jovana Baljak^1,2, Tanja Lakić<sup>1,2

1</sup>University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
²University Clinical Center of Vojvodina, Center for pathology and histology, Novi Sad, Serbia
³Faculty of Pharmacy Novi Sad, University Business Academy in Novi Sad, Novi Sad, Srbija

 

UDK: 616.616.61-006-071

The paper was received / Rad primljen: 21.12.2023

Accepted / Rad prihvaćen: 21.01.2024.

 

Correspondence to:

Aleksandra Ilić
Centar za patologiju i histologiju, Univerzitetski klinički centar Vojovodine
Hajduk Veljkova 3, 21000 Novi Sad
tel. +381 69 1452582
e-mail: aleksandra.m.ilic@mf.uns.ac.rs

 

 

Abstract

 

 

Introduction: Adult cystic nephroma (CN) is a part of mixed epithelial and stromal tumor (MEST) family, constituting about 2.4% of all primary renal lesions. It typically occures in females, especially in postmenopausal women. Case report: We report a case of a 44-year old female who was admitted to Urology Clinic of Clinical Centre of Vojvodina after incidental finding of a mass in her left kidney. The Computed tomography scan showed a 7x6x7 cm, unilocular, well-circumscribed cyst, localized in the middle part and upper pole of the left kidney. Macroscopic examination revealed a well-circumscribed multicystic tumor mass, measuring 7cm. It contained tan-white septa and smooth walls and was filled with clear yellowish fluid. Microscopic examination showed variably sized cysts lined mostly by cuboidal epithelium, with a focal hobnail appearance without atypia, focally flattened. The septa consisted of fibrous stroma with hypercellular areas and areas of cellular con­densation ovarian stroma like. Immunohistochemical analyses showed that epithelial component was positive for Pax 8. The stroma was positive for estrogen receptor, progesterone receptor, actin, desmin, calretinin, CD 10 and partially positive for inhibin α. Conclusion: CN is a rare neoplasm that must be considered in the presence of multicystic changes in the kidney, and which in the absence of clear cells is often misdiagnosed as simple cortical cyst of the kidney. Although there has not been the evidence of local recurrence or metastatic in the literature, the long-term follow-up is recommended.

 

Key words:

cystic nephroma; cyst; kidney

 

 

 

Sažetak

 

Uvod: Adultni cistični nefrom (CN) spada u porodicu mešanih epitelnih i stromalnih tumora (MEST) i čini oko 2,4% svih primarnih bubrežnih lezija. Tipično se javlja kod žena, posebno u postmenopauzi. Prikaz bolesnika: Prikazujemo slučaj 44-godišnje žene koja je primljena na Kliniku za urologiju Kliničkog centra Vojvodine nakon slučajnog pronalaska lezije u levom bubregu. Na kompjuterizovanoj tomografiji uočena je unilokularna, jasno ograničena cista dimenzija 7x6x7 cm, lokalizovana u središnjem delu i gornjem polu levog bubrega. Makroskopskim pregledom opisana je jasno ograničena multicistična tumorska masa, veličine 7 cm, sa žućkasto-beličastim pregradama i glatkim zidovima, ispunjena bistrom žućkastom tečnošću. Mikroskopski, tumor je bio izgrađen od cistarazličite veličine, obloženih uglavnom kubičnim epitelom, sa fokalnim hobnail izgledom bez atipije, mestimičnoaplatiranim. Septe su bile izgrađene od fibrozne strome sa hipercelularnim područjima i oblastima nalik stromi jajnika. Imunohistohemijskom analizom, epitelna komponenta je pokazala pozitivnost na Pax 8. Stroma je bila pozitivna na estrogenski receptor, progesteronski receptor, aktin, desmin, kalretinin, CD 10 i delimično pozitivna na inhibin α. Zaključak: CN je redak tumor na koji se mora misliti u slučaju multicističnih promena u bubregu i koji se u nedostatku svetlih ćelija često pogrešno dijagnostikuje kao jednostavna kortikalna cista bubrega. Iako u literaturi nema dokaza o lokalnom recidivu ili metastazama, preporučuje se dugoročno praćenje.

 

Ključne reči:

cistični nefrom; cista; bubreg

 

 

 

 

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PDF: 07-Milić Z. et al. MD-Medical Data 2024;16(1) 049-052.pdf