Granulomas associated with renal neoplasms: A multi-institutional clinicopathological study of 111 cases.

Autor: Sangoi AR; El Camino Hospital, Pathology, Mountain View, CA, USA., Maclean F; Department of Anatomic Pathology, Douglass Hanly Moir Pathology, Sonic Healthcare, Macquarie Park, Australia., Mohanty S; Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, India., Hes O; Department of Pathology, Charles University Hospital and Medical Facility Plzen, Plzen, Czech Republic., Daniel R; Department of Pathology, University of Pennsylvania, Philadelphia, PA, USA., Lal P; Department of Pathology, University of Pennsylvania, Philadelphia, PA, USA., Canete-Portillo S; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA., Magi-Galluzzi C; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA., Cornejo KM; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA., Collins K; Indiana University, Pathology, Indianapolis, IN, USA., Hwang M; Indiana University, Pathology, Indianapolis, IN, USA., Falzarano SM; Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, USA., Feely MM; Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, USA., Dababneh M; Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA., Harik L; Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA., Tretiakova M; University of Washington, Department of Laboratory Medicine and Pathology, Seattle, WA, USA., Akgul M; Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA., Manucha V; Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA., Chan E; Department of Pathology, University of California San Francisco, San Francisco, CA, USA., Kao CS; Stanford Medical Center, Stanford, CA, USA., Siadat F; Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AL, Canada., Arora K; Department of Pathology, Henry Ford Hospital, Detroit, MI, USA., Barkan G; Loyola University Healthcare Center, Department of Pathology, Maywood, IL, USA., Cheng L; Indiana University, Pathology, Indianapolis, IN, USA., Hirsch M; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Lei L; Department of Pathology and Laboratory Medicine, University of California Davis Health System, Sacramento, CA, USA., Wasco M; St Joseph Mercy Hospital, Ann Arbor, MI, USA., Williamson SR; Department of Pathology, Cleveland Clinic, Cleveland, OH, USA., Acosta AM; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Histopathology [Histopathology] 2022 May; Vol. 80 (6), pp. 922-927. Date of Electronic Publication: 2022 Mar 29.
DOI: 10.1111/his.14633
Abstrakt: Aims: Formal depiction of granulomatous inflammation associated with renal neoplasms has mainly consisted of case reports. Herein, we investigate the clinicopathological features and potential significance of granulomas associated with renal tumours from a large multi-institutional cohort.
Methods and Results: One hundred and eleven study cases were collected from 22 institutions, including 57 partial nephrectomies and 54 radical nephrectomies. Patient ages ranged from 27 to 85 years (average = 60.1 years; male = 61%). Renal neoplasms included clear cell renal cell carcinoma (RCC; 86%), papillary RCC (8%), chromophobe RCC (3%), clear cell papillary RCC (1%), mixed epithelial stromal tumour (1%) and oncocytoma (1%). Granulomas were peritumoral in 36%, intratumoral in 24% and both in 40% of cases. Total granuloma count per case ranged from one to 300 (median = 15) with sizes ranging from 0.15 to 15 mm (mean = 1.9 mm). Necrotising granulomas were seen in 14% of cases. Histochemical stains for organisms were performed on 45% of cases (all negative). Sixteen cases (14%) had a prior biopsy/procedure performed, and eight patients had neoadjuvant immunotherapy or chemotherapy. Eleven patients (10%) had a confirmed diagnosis of sarcoidosis, including five in whom sarcoidosis was diagnosed after nephrectomy.
Conclusion: Based on this largest case-series to date, peri-/intratumoral granulomas associated with renal neoplasms may be more common than initially perceived. The extent of granulomatous inflammation can vary widely and may or may not have necrosis with possible aetiologies, including prior procedure or immunotherapy/chemotherapy. Although a clinical association with sarcoidosis is infrequent it can still occur, and the presence of granulomas warrants mention in pathology reports.
(© 2022 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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