Granulomas associated with renal neoplasms: A multi‐institutional clinicopathological study of 111 cases
Autor: | Ankur R Sangoi, Fiona Maclean, Sambit Mohanty, Ondrej Hes, Reba Daniel, Priti Lal, Sofia Canete‐Portillo, Cristina Magi‐Galluzzi, Kristine M Cornejo, Katrina Collins, Michael Hwang, Sara M Falzarano, Mike M Feely, Melad Dababneh, Lara Harik, Maria Tretiakova, Mahmut Akgul, Varsha Manucha, Emily Chan, Chia‐Sui Kao, Farshid Siadat, Kanika Arora, Guliz Barkan, Liang Cheng, Michelle Hirsch, Li Lei, Matthew Wasco, Sean R Williamson, Andres M Acosta |
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Rok vydání: | 2022 |
Předmět: |
Adult
Male kidney Kidney Disease Histology Sarcoidosis granulomas peritumoral Clinical Sciences carcinoma Autoimmune Disease Pathology and Forensic Medicine Rare Diseases Clinical Research 80 and over sarcoid-like Pathology Humans Carcinoma Renal Cell Cancer Aged Aged 80 and over Inflammation Granuloma Renal Cell General Medicine Middle Aged Kidney Neoplasms intratumoral renal Female sarcoid neoplasm |
Zdroj: | Histopathology, vol 80, iss 6 |
ISSN: | 1365-2559 0309-0167 |
Popis: | AimsFormal 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 resultsOne 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.ConclusionBased 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. |
Databáze: | OpenAIRE |
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