Flat pattern of nephrogenic adenoma: previously unrecognized pattern unveiled using PAX2 and PAX8 immunohistochemistry

Piña‐Oviedo, Sergio; Shen, Steven S.; Truong, Luan D.; Ayala, Alberto G.; Ro, Jae Y.

doi:10.1038/modpathol.2012.239

Cited by 35 publications

(15 citation statements)

References 17 publications

(29 reference statements)

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“…[ 14 ] In addition, a flat pattern was first described in 2013, and was found in 8 of 15 cases of NA, often mixed with the more traditional tubular, polypoid, and papillary components. [ 15 ] Besides, they also found that flat pattern was a common histomorphological manifestation of NA but could be easily confused with atypical flat urothelial lesions. [ 15 , 16 ] In this case, the histomorphology showed a mixed arrangement of papillary and tubular patterns.…”

Section: Discussionmentioning

confidence: 99%

Nephrogenic adenoma of the renal pelvis

Zhang¹,

Wu²,

Sun³

et al. 2021

Medicine

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Rationale: Nephrogenic adenoma (NA) is a rare benign lesion of the urinary tract, which rarely occurs in the renal pelvis. Only 19 cases have been reported in the literature. However, there is no detailed report on the clinicopathological features of NA of the renal pelvis. Patient concerns: This case report describes a 46-year-old male patient who was admitted to the hospital for one month because of painless gross hematuria with blood clots. He had a history of hyperuricemia and a family history of gastric cancer. Diagnoses: NA of the renal pelvis was diagnosed pathologically and immunohistochemical. Interventions: The patient underwent laparoscopic nephroureterectomy. Outcomes: The patient recovered well after the operation with no discomfort. In addition, we followed up with the patient regularly post-discharge (approximately 20 months). There were no obvious abnormalities in the results of routine urine culture, computed tomography scan of the abdomen, and cystoscopy during the follow-up period, and the symptoms disappeared completely and did not recur. Lessons: NA of the renal pelvis is extremely rare in the clinic, which can be easily misdiagnosed and overtreated. However, for pathological diagnosis of this disease, specific immunohistochemical staining for preoperative biopsy was reported to be significant, which should be considered by the urologists and pathologists.

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Section: Discussionmentioning

confidence: 99%

Nephrogenic adenoma of the renal pelvis

Zhang¹,

Wu²,

Sun³

et al. 2021

Medicine

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“…Intriguing support for this possibility exists in patients with the rare condition of nephrogenic adenoma, a benign lesion of the bladder or urethra observed most frequently in patients with a history of bladder injury, inflammation, infection, kidney stones, or urogenital surgeries (18,19). Presence of PAX2-and PAX8-immunopositive cells in bladder and urethral biopsies is diagnostic for nephrogenic adenoma (20), but the source of these cells is not completely known. One study demonstrated that exfoliated kidney epithelial cells from donors colonize bladders of kidney transplant recipients who later developed nephrogenic adenoma (18).…”

Section: Discussionmentioning

confidence: 99%

In vivo replacement of damaged bladder urothelium by Wolffian duct epithelial cells

Joseph

Chandrashekar

Abler

et al. 2018

Proc. Natl. Acad. Sci. U.S.A.

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The bladder's remarkable regenerative capacity had been thought to derive exclusively from its own progenitors. While examining consequences of DNA methyltransferase 1 () inactivation in mouse embryonic bladder epithelium, we made the surprising discovery that Wolffian duct epithelial cells can support bladder regeneration. Conditional inactivation in mouse urethral and bladder epithelium triggers widespread apoptosis, depletes basal and intermediate bladder cells, and disrupts uroplakin protein expression. These events coincide with Wolffian duct epithelial cell recruitment into mutant urethra and bladder where they are reprogrammed to express bladder markers, including FOXA1, keratin 5, P63, and uroplakin. This is evidence that Wolffian duct epithelial cells are summoned in vivo to replace damaged bladder epithelium and function as a reservoir of cells for bladder regeneration.

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“…[99][100][101][102] Expected Expression in Tumors.-PAX8 is expressed in most types of RCC, including clear cell RCC (80%-98%), papillary RCC (76%-95%), chromophobe RCC (80%-100%), mucinous tubular and spindle cell RCC (100%), clear cell tubulopapillary RCC (100%), sarcomatoid RCC (29%-44%), and metastatic RCC (85%-100%). [99][100][101][102][103][104] Other renal carcinomas also express PAX8, including collecting duct carcinoma (50%-100%) and renal medullary carcinoma (100%) as well as some benign renal neoplasms (eg, oncocytoma, 61%-95%; nephrogenic adenomas, 100%; and mixed epithelial and stromal tumors, 100%). [99][100][101][102][103]105 However, although PAX8 has great sensitivity for renal neoplasms, we and others have seen PAX8 immunoreactivity in a few upper tract urothelial carcinomas (9%-23%), which can be misleading in diagnosing poorly differentiated tumors arising around the renal pelvis.…”

Section: Pax Proteinsmentioning

confidence: 99%

“…[99][100][101][102][103][104] Other renal carcinomas also express PAX8, including collecting duct carcinoma (50%-100%) and renal medullary carcinoma (100%) as well as some benign renal neoplasms (eg, oncocytoma, 61%-95%; nephrogenic adenomas, 100%; and mixed epithelial and stromal tumors, 100%). [99][100][101][102][103]105 However, although PAX8 has great sensitivity for renal neoplasms, we and others have seen PAX8 immunoreactivity in a few upper tract urothelial carcinomas (9%-23%), which can be misleading in diagnosing poorly differentiated tumors arising around the renal pelvis. [99][100][101]106 Most thyroid carcinomas also stain for PAX8, including papillary carcinoma (100%), follicular carcinoma (91%-100%), poorly differentiated carcinoma (75%-100%), undifferentiated carcinoma (50%), anaplastic carcinoma (79%-80%), and medullary carcinoma (41%-75%).…”

Section: Pax Proteinsmentioning

confidence: 99%

Practical Application of Lineage-Specific Immunohistochemistry Markers: Transcription Factors (Sometimes) Behaving Badly

Kei

Adeyi

2019

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Transcription factors (TFs) are proteins that regulate gene expression and control RNA transcription from DNA. Lineage-specific TFs have increasingly been used by pathologists to determine tumor lineage, especially in the setting of metastatic tumors of unknown primary, among other uses. With experience gathered from its daily application and increasing pitfalls reported from immunohistochemical studies, these often-touted highly specific TFs are not as reliable as once thought. Objectives.— To summarize the established roles of many of the commonly used TFs in clinical practice and to discuss known and potential sources for error (eg, false-positivity from cross-reactivity, aberrant, and overlap “lineage-specific” expression) in their application and interpretation. Data Sources.— Literature review and the authors' personal practice experience were used. Several examples selected from the University Health Network (Toronto, Ontario, Canada) are illustrated. Conclusions.— The application of TF diagnostic immunohistochemistry has enabled pathologists to better assess the lineage/origin of primary and metastatic tumors. However, the awareness of potential pitfalls is essential to avoid misdiagnosis.

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Flat pattern of nephrogenic adenoma: previously unrecognized pattern unveiled using PAX2 and PAX8 immunohistochemistry

Cited by 35 publications

References 17 publications

Nephrogenic adenoma of the renal pelvis

Nephrogenic adenoma of the renal pelvis

In vivo replacement of damaged bladder urothelium by Wolffian duct epithelial cells

Practical Application of Lineage-Specific Immunohistochemistry Markers: Transcription Factors (Sometimes) Behaving Badly

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