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Presented by Dr. Andres Matoso and prepared by Dr. Harsimar Kaur.
Adult female with kidney tumor.
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1. Question
Adult female with kidney tumor.
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Histology: This is a biphasic tumor composed of solid stromal areas and cystic structures lined by cuboidal epithelium with areas with hobnailed appearance.
Discussion: Cystic nephroma (CN) and mixed epithelial and stromal tumors (MEST) are considered morphologic spectrums of the same lesion. Tumors that are composed entirely of cysts and cysts sepate without any solid expansile areas or mural nodules are called CN. Tumors with variable amounts of solid components are called MEST. There is a marked female predominance and tumors frequently express ER and PR in the mesenchymal cells. They are most commonly benign, well circumscribed and located near the hilum. Features of malignancy include irregular border, high cellularity, cytologic atypia and frequent mitoses. Immunohistochemistry highlights ER and PR in stromal cells and inhibin or calretinin in both epithelial cells and stromal cells.
References:
1. Chuang CK, Pan PY, Kao Y, Chou YC, Ng KF, Wang LJ, Tsai HY, Lee KH. Mixed epithelial stromal tumor of the kidney: The male case and literature review. Urol Case Rep. 2018 Jan 31;17:122-124.Incorrect
Histology: This is a biphasic tumor composed of solid stromal areas and cystic structures lined by cuboidal epithelium with areas with hobnailed appearance.
Discussion: Cystic nephroma (CN) and mixed epithelial and stromal tumors (MEST) are considered morphologic spectrums of the same lesion. Tumors that are composed entirely of cysts and cysts sepate without any solid expansile areas or mural nodules are called CN. Tumors with variable amounts of solid components are called MEST. There is a marked female predominance and tumors frequently express ER and PR in the mesenchymal cells. They are most commonly benign, well circumscribed and located near the hilum. Features of malignancy include irregular border, high cellularity, cytologic atypia and frequent mitoses. Immunohistochemistry highlights ER and PR in stromal cells and inhibin or calretinin in both epithelial cells and stromal cells.
References:
1. Chuang CK, Pan PY, Kao Y, Chou YC, Ng KF, Wang LJ, Tsai HY, Lee KH. Mixed epithelial stromal tumor of the kidney: The male case and literature review. Urol Case Rep. 2018 Jan 31;17:122-124.
