Cystic nephroma

A cystic nephroma, also known as multilocular cystic nephroma, mixed epithelial stromal tumour (MEST) and renal epithelial stromal tumour (REST),[1] is a type of rare benign kidney tumour.

Cystic nephroma
Micrograph of a cystic nephroma (left of image). Normal kidney is seen on the right. H&E stain.
SpecialtyOncology 

Symptoms

Cystic nephromas are often asymptomatic. They are typically discovered on medical imaging incidentally (i.e. an incidentaloma).

Diagnosis

Cystic nephromas are diagnosed by biopsy or excision. It is important to correctly diagnose them as, radiologically, they may mimic the appearance of a renal cell carcinoma that is cystic.[2]

Pathologic diagnosis
High magnification micrograph of a cystic nephroma showing the characteristic simple epithelium with hobnail morphology, and the ovarian-like stroma. H&E stain.

The characteristics of cystic nephromas are:

  • Cysts lined by a simple epithelium with a hobnail morphology, i.e. the nuclei of the cyst lining epithelium bulges into the lumen of the cysts,
  • Ovarian-like stroma that has a:

Cystic nephromas have an immunostaining pattern like ovarian stroma; they are positive for:

  • Estrogen receptor (ER),
  • Progesterone receptor (PR) and
  • CD10.

Differential diagnosis

Additional images

References
  1. Turbiner J, Amin MB, Humphrey PA, et al. (April 2007). "Cystic nephroma and mixed epithelial and stromal tumor of kidney: a detailed clinicopathologic analysis of 34 cases and proposal for renal epithelial and stromal tumor (REST) as a unifying term". Am. J. Surg. Pathol. 31 (4): 489–500. doi:10.1097/PAS.0b013e31802bdd56. PMID 17414095.
  2. Small JE et al. Cystic Nephroma. BrighamRAD Teaching Case Database. URL: http://brighamrad.harvard.edu/Cases/bwh/hcache/385/full.html Archived 2004-10-24 at Archive.today. Accessed: July 25, 2009.
Classification
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