Papillary adenoma of the kidney is a benign renal neoplasm arising from the renal tubular epithelium and almost always located within the cortex. It falls under the general category of renal adenomas and is considered one of the commonest of renal epithelial neoplasms.
The estimated prevalence rate is at approximately 40% in patients older than 70 years of age (according to autopsy series).
Most papillary adenomas are asymptomatic.
A papillary adenoma-to-carcinoma sequence has been described that is akin to similar transformation in colonic adenomas.
By definition, papillary adenomas measure 5 mm or less 1,4. They are usually subcapsular and solitary.
Adenomas are histologically characterized by papillary or tubular cytoarchitecture and frequent psammoma bodies.
Cytogenetic changes of papillary adenomas include loss of the Y chromosome and combined trisomy of chromosomes 7 and 17. Histologic and genetic abnormalities of renal adenomas are indistinguishable from papillary RCCs.
- von Hippel Lindau disease 5
- papillary adenomas are also commonly found in patients with acquired renal cystic disease and in patients undergoing long-term haemodialysis: papillary adenomas in these patients may have different pathogenesis 4.
Papillary adenomas are usually extremely small (<5 mm) and may not be distinguished from other renal tumours (particularly RCC/papillary renal carcinoma pRCC) and renal pseudotumours on imaging.
- renal papillary adenomatosis: presence of multiple papillary adenomas
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- 3. Wang KL, Weinrach DM, Luan C et-al. Renal papillary adenoma--a putative precursor of papillary renal cell carcinoma. Hum. Pathol. 2007;38 (2): 239-46. doi:10.1016/j.humpath.2006.07.016 - Pubmed citation
- 4. Quaia E. Radiological Imaging of the Kidney. Springer Verlag. (2011) ISBN:3540875964. Read it at Google Books - Find it at Amazon
- 5. Nargund VH, Raghavan D, Sandler HM. Urological Oncology. Springer Verlag. (2007) ISBN:1846283876. Read it at Google Books - Find it at Amazon