Histopathological analysis and reporting of renal lesions in Nephrectomy specimens: A 3-year descriptive study at Tertiary Care Hospital
Keywords:Pyelonephritis, Clear Cell Renal Cell Carcinoma, Renal Oncocytoma, Renal Cell Carcinoma.
Background: Kidneys are paired retroperitoneal organs and are the one, among the most highly differentiated organs in the body. They regulate several complex physiologic processes and, are greatly impacted by a broad spectrum of pathological conditions. In urology practice, nephrectomy (removal of entire or part of the kidney) is the widely performed surgical procedure for end-stage/nonfunctioning kidneys or any renal mass. Objectives: 1. Based on histomorphology, the main objective of our study is to analyze the spectrum and frequency of the different renal lesions in nephrectomy specimens at our tertiary care hospital. 2. To know the common indication/ cause for the nephrectomy procedure. 3. And also to study the distribution of renal lesions including both neoplastic and non-neoplastic lesions concerning age, gender, and histomorphological features. Materials and Methods: This was a retrospective and prospective review of histopathological lesions encountered in different age groups & genders amongst nephrectomy specimens received in the Department of Pathology, Katuri Medical college Chinnakondrupadu, Guntur, Andra Pradesh, India. Results: In this study, the most common lesions were non-neoplastic (53.3%, 16 cases), the vast majority being chronic pyelonephritis accounting for 23.4% (07 cases). The neoplastic lesions accounting for 46.7% (14 cases), the majority were malignant neoplasms 13 cases in number and only one case of benign neoplasm was reported. Clear cell renal cell carcinoma was the most common malignant renal tumor and Oncocytoma was the only benign tumor reported in our study. And also we reported a rare case of coexisting urothelial carcinoma and renal tuberculosis in the same kidney on the left side in a 54-year-old female patient with a previous history of treated pulmonary tuberculosis. The most common age group affected was the 4th to 6th decade of life. Both non-neoplastic and neoplastic lesions show male preponderance. Conclusion: This study highlights that a complete and detailed histopathological examination of every nephrectomy specimen is mandatory to know the histologic type, for tumor grading and stating In summary, not only the pathologist, every clinician should have a better understanding of the histomorphology of renal lesions that are found in nephrectomy specimens to facilitate earlier diagnosis and more targeted treatment options, thereby improving overall and disease-free survival of the patient. In our study, non-neoplastic lesions were more the most common, followed by malignant tumors, and the least common were benign tumors. Chronic pyelonephritis was the most common non-neoplastic lesion for which nephrectomy was done. Clear cell renal cell carcinoma was the most common malignant tumor and Oncocytoma was the only benign tumor reported. Also reported, a rare and interesting case of coexisting papillary urothelial carcinoma and renal tuberculosis in the same side of the kidney. The most commonly affected age group was the 4th to 6th decade of life. Both non-neoplastic and neoplastic lesions showed male preponderance.
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Copyright (c) 2021 Muni Bhavani Itha, Yarlagada Krishna Bharathi, Satyanarayana Veeragandham
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