Localized Cystic Disease of the Kidney Masquerading as Cystic Neoplasms
Ming Zhou, Longwen Chen, Rong Fan, Stephen Bonsib. New York Universiy, New York, NY; Mayo Clinic Arizona, Scottsdale, AZ; Indiana University Medical School, Indianapolis, IN; Louisiana State University Health Sciences Center, Shreveport, LA
Background: Cystic changes are common in both neoplastic and non-neoplastic kidney diseases. Some non-neoplastic cystic kidney lesions can be mistaken for cystic neoplasms clinically and radiographically. Accurate diagnosis is critical for patient management. We report the clinicopathological and radiological characteristics of 6 cases of a rare, non-genetic and non-progressive cystic disease, localized cystic disease of the kidney (LCD), that mimicked renal neoplasms and were treated surgically.
Design: LCD was defined as a non-genetic, non-progressive, non-neoplastic and localized cystic lesion. Six such cases were retrieved from the surgical pathology archives of authors' institutions and their clinicopathological and radiological characteristics were analyzed.
Results: Six patients had a mean age of 32.8 years (range 10-56) and included 3 males and 3 females. Two patients had gross hematuria while LCD was discovered incidentally in remaining 4 patients. No personal or family history of cystic renal disease was found in any patient. One patient had solitary kidney rendered by contralateral nephrectomy for renal cell carcinoma. Preoperative imaging studies showed multilocular cystic lesions with a mean size of 3.3 cm (range 2.1-6) and Bosniak II lesion in 3 and Bosniak III lesion in 3 patients. Partial and total nephrectomy was performed in 5 and 1 patients. All 6 lesions arose in the renal papillae without a capsule. Cystic changes also involved overlying cortex in 2 cases. Cysts were lined with cuboidal or flat cells identical to those lining the collecting ducts.
Some cysts were continuous with dilated collecting ducts. Significant inflammation was absent. Single 4-mm urolith was found in one case.
Conclusions: LCD is a rare, non-genetic, non-progressive, non-neoplastic and localized cystic lesion with a characteristic location within the renal papillae. Knowledge of its pathological features can help avoiding misdiagnosing it as cystic neoplasms and may assist preoperative imaging diagnosis.
Category: Genitourinary (including renal tumors)
Wednesday, March 21, 2012 9:30 AM
Poster Session V # 89, Wednesday Morning