HISTOMORPHOLOGICAL EVALUATION OF LESIONS IN NEPHRECTOMY SPECIMENS.

Abstract

Background: Nephrectomy either partial or radical has become a common procedure in surgical and urological practice. In this study pathological reports were interpreted for the following parameters: age, gender, pathological diagnosis. An indication of nephrectomy depends on type of lesion, extent of damage, general condition of patient and status of contralateral kidney. Method: The present ambiceptive data analysis has been carried out in Department of Pathology in tertiary care centre under Maharashtra University of Health Sciences by histopathological examination of nephrectomy specimens. A Results: total of 59 nephrectomy cases were included in the study. Non neoplastic and neoplastic cases were 44 (75%) and 15 (25%) respectively. Among non-neoplastic lesions, total of 32 cases (72%) were diagnosed as Chronic pyelonephritis with End Stage Renal Disease(ESRD) . Others Chronic Xanthogranulomatous Pyelonephritis with ESRD 9 cases (21%) and Chronic Glomerulonephritis with ESRD 3 cases (7%). Neoplastic lesions constitutes 15 cases with peak in 6th decade. Renal Cell Carcinoma(RCC) is the most common neoplastic lesion. The distribution among the neoplastic lesions include: Clear cell RCC (40%), Papillary RCC (13.34%), Mixed RCC (13.34%), Chromophobe RCC (13.34%), Multicystic nephroma (6.67%), Collecting duct carcinoma (6.67%) and Renal Medullary carcinoma (6.67%). Fuhrman's nuclear grade II is the most common among the RCC. Rare case such as Collecting Duct carcinoma, Renal Medullary carcinoma and Sarcomatoid RCC were diagnosed during the study period. On IHC, Collecting Duct carcinoma is positive for HMW CK, PAX8 and Renal medullary carcinoma is positive for Vimentin. The histopathological Conclusion: examination is essential to differentiate between benign and malignant neoplastic lesions and in grading of malignant lesions which help in treatment and further management of patients.