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Donor kidneys with miliary papillary renal cell neoplasia: the role of the pathologist in determining suitability for transplantation
- Source :
- Annals of transplantation. 19
- Publication Year :
- 2014
-
Abstract
- BACKGROUND Kidneys with single or multiple tumors, provided that they have histological features recognized as being associated with low risk of recurrence, are considered suitable for transplantation. It is known that kidneys with multiple primary renal tumors show poor renal function and that function dramatically declines when tumors have a miliary configuration. Despite this, no guidelines are in place to differentiate between multifocal tumors and those that are miliary in nature. CASE REPORT We report a case in which initial examination revealed papillary renal cell neoplasia in deceased donor kidneys, which were later confirmed on histological and genetic testing to be multiple and miliary in distribution. Gross examination showed closely opposed neoplasms, and on histological examination these were found to be papillary renal cell carcinomas and renal papillary adenomas. This ultimately led to the decision that both kidneys were unsuitable for transplantation. CONCLUSIONS At present there are no recommendations as to how tumor-bearing donor kidneys should be handled in order to determine if miliary neoplasia is present. From our case it is apparent that, in addition to obvious tumor nodules, at least 3 samples of cortex should be examined. This case highlights the important role of the pathologist in assessing donor kidneys with evidence of neoplasia.
- Subjects :
- Adenoma
Male
Pathology
medicine.medical_specialty
Tissue and Organ Procurement
papillary renal cell neoplasia
renal tumors
kidney carcinoma
Renal function
Kidney
Gross examination
Cortex (anatomy)
Carcinoma
Cadaver
Medicine
Humans
Carcinoma, Renal Cell
Kidney transplantation
Papillary renal cell carcinomas
business.industry
TRANSPLANTATION
Papillary Adenoma
Kidneys
General Medicine
DNA, Neoplasm
transplantation
Middle Aged
medicine.disease
Kidney Transplantation
Kidney Neoplasms
Tissue Donors
Transplantation
medicine.anatomical_structure
business
Subjects
Details
- ISSN :
- 23290358
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- Annals of transplantation
- Accession number :
- edsair.doi.dedup.....4e68540e23ec9b3c4e1ee6a4ffc6431f