Study of Histopathological Spectrum of Renal Neoplasms in Nephrectomy Specimens from a Tertiary Hospital in North Karnataka, India

• Main Authors: Basavaraj Yamakanamardi, Hephzibah Rani, Udupi Shastry Dinesh
• Format: Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd. 2018-07-01
• Series: National Journal of Laboratory Medicine
• Subjects: chromophobe; oncocytoma; renal cell carcinoma; synovial sarcoma; wilms tumour
• Online Access: http://www.njlm.net/articles/PDF/2297/36962_CE(VSU)_F(AnG)_PF1(VSU_SHU)_PFA(SHU)_PB(VSU_SHU)_PN(SS).pdf

Introduction: Renal Cell Carcinoma (RCC) ranks 13th most common malignancy worldwide. Majority of the renal tumours are RCCs with very few cases presenting with the classical triad of flank pain, haematuria and mass per abdomen. Partial or total nephrectomy remains the treatment of choice in these patients. A systematic gross and microscopic examination of nephrectomy specimens is pivotal in determining the tumour type and its prognostic indicators namely tumour grade and stage for arriving at a complete treatment protocol. Aim: This study from a tertiary care hospital was undertaken to determine the most common clinical presentation, with age and sex distribution of renal tumours and to analyse the histomorphological spectrum of renal tumours from resected nephrectomy specimens. Materials and Methods: A total of 32 nephrectomy cases were studied during this period. Histopathological parameters were assessed as per CAP guidelines 2017. Tumours were sub typed according to WHO classification 2016 and Fuhrman’s nuclear grade and TNM tumour stage were assessed. The statistical analysis was done using the Statistical Package for the Social Sciences version 20.0 (SPSS Inc. Chicago, IL, USA). Results: The present study included 32 cases. The mean age of presentation was 43.43 years with flank pain being the most common clinical presentation in 17 (53.1%) cases. Histopathological evaluation revealed malignant neoplasm in 28 (87.5%) cases and benign neoplasm in 4 (12.5%) cases. Among malignant tumours, clear cell RCC was the most frequent tumour in our study observed in 15 (46.9%) cases, followed by papillary RCC in 5 (15.6%) cases, 3 (9.4%) cases of Wilms tumour, 2 (6.3%) cases of squamous cell carcinoma, and 1 (3.1%)case each of synovial sarcoma, chromophobe rcc and rhabdoid tumour. Conclusion: Malignant renal tumours far out numbered the benign tumours in our study with RCC being the most common malignant tumour in adults. Wilms tumour was the most common malignancy in paediatric age group. Majority of the tumours showed Fuhrman’s nuclear Grade 2 seen in 50% of the cases.