Cystic nephroma (pathology)

Case contributed by Dr Andrew Ryan

Presentation

Multilocular cystic lesion on imaging.

Patient Data

Age: 50 years
Pathology

Partly collapsed but well circumscribed multilocular cystic lesion in the upper pole of the kidney

Pathology

Histology showing variably sized cysts separated by thin septae lined by benign 'non-clear cell' epithelium.

Low power (x10) histology showing variably sized cysts separated by thin septae, with a small amount of adjacent parenchyma (upper left).

Medium power (x200) histology showing variably sized cysts separated by thin septae composed of fibrous to spindled stroma, in areas with 'ovarian-like' qualities. 

High power (x400) histology showing fibrous to spindled septae lined by bland epithelium with 'hob-nail' appearance.

Case Discussion

Cystic nephroma is an uncommon benign lesion of the kidney, most often presenting as a well circumscribed multilocular cyst. The important differential diagnosis to exclude in adults is cystic renal cell carcinoma. 

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