Simple Nephrectomy for Non-Functioning Kidney: An Institutional Experience with Non-Neoplastic and Incidentally Detected Neoplastic Lesions.

IF 0.9 4区 医学 Q4 PATHOLOGY
Maitrayee Roy, Akshay Bali, Ayushi Kediya, Vishesh Dhawan, Vijay Shrawan Nijhawan
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引用次数: 0

Abstract

Introduction. Chronic kidney diseases are attributed to a variety of etiologies, including diabetes mellitus, hypertension, vascular diseases, cystic kidney diseases, chronic tubulo-interstitial diseases, chronic pyelonephritis, and glomerular diseases. Simple nephrectomy is indicated when the loss of renal function in a unilateral non-functional kidney is permanent in a persistently symptomatic patient. Uncommonly, a non-functional kidney may develop neoplasm unsuspected pre-operatively and be diagnosed only during histopathological examination of nephrectomy specimen. Material and methods. We examined 275 simple nephrectomies performed between 2019 and 2024 in patients with non-functional kidneys confirmed by DMSA scan. All nephrectomies done for diagnosed or even suspected tumors by pre-operative imaging were excluded from the study. Results. Chronic pyelonephritis (79.3%) was the most common histopathological diagnosis, followed by xanthogranulomatous pyelonephritis (8.7%) and granulomatous pyelonephritis (5.4%). In five (1.8%) patients, microscopy revealed non-specific chronic interstitial inflammation and interstitial fibrosis. One patient (0.4%) was diagnosed with large solitary pyelogenic cyst and renal nocardiosis. Eleven patients (4%) were diagnosed with neoplasms. Clear cell renal cell carcinoma was the most common diagnosis (27.2%), followed by urothelial carcinomas of renal pelvis (18.2%), one patient each of collecting duct carcinoma, squamous cell carcinoma of renal pelvis, and multilocular cystic renal neoplasm of low malignant potential. Three patients had papillary adenomas. Conclusion. Diligent histopathological examination of simple nephrectomy is crucial in establishing the final diagnosis with important further therapeutic implications. This is especially important in neoplastic pathologies developing in non-functional kidneys that may rarely be unsuspected by pre-operative imaging and diagnosed only during histopathological evaluation.

无功能肾的简单肾切除术:非肿瘤和偶然发现的肿瘤病变的机构经验。
介绍。慢性肾病的病因多种多样,包括糖尿病、高血压、血管疾病、囊性肾病、慢性小管间质疾病、慢性肾盂肾炎和肾小球疾病。当单侧无功能肾脏永久性丧失,且症状持续时,建议行单纯肾切除术。罕见的是,无功能的肾脏可能在术前未被怀疑的情况下发生肿瘤,只有在肾切除术标本的组织病理学检查中才能被诊断出来。材料和方法。我们研究了2019年至2024年间进行的275例简单肾切除术,这些患者均为DMSA扫描证实的无功能肾脏。所有因术前影像学诊断或疑似肿瘤而进行的肾切除术均被排除在本研究之外。结果。慢性肾盂肾炎(79.3%)是最常见的组织病理学诊断,其次是黄色肉芽肿性肾盂肾炎(8.7%)和肉芽肿性肾盂肾炎(5.4%)。在5例(1.8%)患者中,显微镜检查显示非特异性慢性间质性炎症和间质性纤维化。1例(0.4%)诊断为大单发肾盂源性囊肿和肾诺卡菌病。11例患者(4%)被诊断为肿瘤。透明细胞肾细胞癌是最常见的诊断(27.2%),其次是肾盂尿路上皮癌(18.2%),收集管癌、肾盂鳞状细胞癌和低恶性潜能的多室囊性肾肿瘤各1例。3例患者有乳头状腺瘤。结论。单纯肾切除术的组织病理学检查对于确定最终诊断和进一步的治疗意义至关重要。这对于发生在无功能肾脏的肿瘤病变尤其重要,这些病变在术前影像学检查中很难不被发现,只能在组织病理学评估中诊断出来。
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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
198
审稿时长
1 months
期刊介绍: International Journal of Surgical Pathology (IJSP) is a peer-reviewed journal published eight times a year, which offers original research and observations covering all major organ systems, timely reviews of new techniques and procedures, discussions of controversies in surgical pathology, case reports, and images in pathology. This journal is a member of the Committee on Publication Ethics (COPE).
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