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Hinyokika Kiyo. Acta Urologica Japonica May 1990We report a case of papillary adenoma of the prostatic urethra composed of prostatic-type epithelial tissue. The patient was a 48-year-old male with complaint of... (Review)
Review
We report a case of papillary adenoma of the prostatic urethra composed of prostatic-type epithelial tissue. The patient was a 48-year-old male with complaint of urethral bleeding. Tumor was transurethrally resected. Sixty one such cases (males, 17-82 years old) have been reported in Japan. Of these patients, 31 (51%) were between 30 and 49 years old, the mean age was 43.9 years old. The lesion was located on the verumontanum (20%) and around the verumontanum (80%). The general symptom was hematuria (65.6%) and sometimes hemospermia (11.5%), dysuria (9.8%). Cautious fulguration was generally performed and the recurrence was reported in 4 cases (6.7%). It is believed to be a completely benign lesion, since no cases of malignant transformation has been reported. However, we must note that 3 cases (4.9%) had a malignant tumor in the lower urinary tract (bladder 1, urethra 2) at the same time.
Topics: Antigens, Neoplasm; Cystadenoma; Epithelium; Humans; Immunohistochemistry; Male; Middle Aged; Prostate-Specific Antigen; Urethral Neoplasms
PubMed: 1698014
DOI: No ID Found -
Histopathology Jun 2021Papillary renal neoplasm with reverse polarity (PRNRP) is a newly defined entity with distinct histomorphology and recurrent KRAS mutation. It has been estimated to...
AIMS
Papillary renal neoplasm with reverse polarity (PRNRP) is a newly defined entity with distinct histomorphology and recurrent KRAS mutation. It has been estimated to constitute 4% of previously diagnosed papillary renal cell carcinoma (PRCC). Renal papillary adenoma (PA) is suggested to be the precursor of PRCC. This study aimed to investigate the association between PRNRP and PA, particularly the morphologically similar type D PA.
METHODS AND RESULTS
Nephrectomy specimens of PRCC and PA from our 10-year pathology archives were retrieved and reviewed. GATA3 immunohistochemistry and RAS/BRAF testing were performed in all cases reclassified as PRNRP and all PAs with sufficient materials. Overall, PRNRP accounted for 9.1% (10 of 110) of PRCC and there was no recurrence/metastasis with a mean follow-up period of 39 months. Three novel morphological features were described, including clear cell change, mast cell infiltration and metaplastic ossification. Nine of the 10 PRNRPs showed diffuse and strong GATA3 expression and KRAS missense mutations at codon 12. One case exhibited moderate GATA3 staining on 80% of the tumour cells and RAS/BRAF wild-type. In a total of 73 PAs, 11 were classified as type D. GATA3 expression was significantly more frequent in type D versus non-type D PAs (100 versus 35%, P < 0.01). KRAS missense mutations were identified in six of eight (75%) of the type D PAs but none of the 18 non-type D PAs.
CONCLUSIONS
Type D PA was different from other types of PA and represented an analogue or a small-sized PRNRP for their identical morphology, immunophenotype and molecular signature.
Topics: Adenoma; Aged; Aged, 80 and over; Biomarkers, Tumor; Carcinoma, Papillary; Carcinoma, Renal Cell; Diagnosis, Differential; Female; GATA3 Transcription Factor; Humans; Immunohistochemistry; Kidney; Kidney Neoplasms; Male; Middle Aged; Mutation; Proto-Oncogene Proteins p21(ras)
PubMed: 33351968
DOI: 10.1111/his.14320 -
Archives of Pathology & Laboratory... May 2022Nephrogenic adenoma (NA) is a common urinary tract lesion typically associated with urothelial disruption, leading to implantation of shed renal tubular cells. NA may...
CONTEXT.—
Nephrogenic adenoma (NA) is a common urinary tract lesion typically associated with urothelial disruption, leading to implantation of shed renal tubular cells. NA may demonstrate a spectrum of architectural and cytologic features mimicking urothelial carcinoma (UC), adenocarcinoma (including clear cell adenocarcinoma and prostatic adenocarcinoma), and invasion. However, admixed UC and NA has not been described.
OBJECTIVE.—
To describe cases where the NA was intimately intermixed with UC, potentially mimicking variant differentiation or invasion.
DESIGN.—
In 3 health care systems we identified specimens of NA and UC intimately intermixed with each other to the extent that they could mimic a spectrum of one lesion. We assessed patterns of NA and clinical implications of misdiagnosing NA as glandular differentiation of UC.
RESULTS.—
There were 4 women and 29 men (median age, 72 years; range, 31-89 years). Twenty-four patients had transurethral resections, 3 had biopsies, and 6 had major resections. Fourteen had noninvasive high-grade papillary UC, 6 had carcinoma in situ, and 11 had invasive high-grade UC. In 2 patients, NA developed in a papillary urothelial neoplasm with extensive denudation. Three patients had fibromyxoid NA infiltrated by invasive UC. Classical NA (n = 30) had tubulopapillary (n = 18), pure tubular (n = 7), or pure papillary architecture (n = 5). In 1 lesion, NA was present in muscularis propria, and 2 lesions involved adventitia. NA could have been misdiagnosed as invasion in 17 of 22 (77%) noninvasive tumors or higher stage in 19 of 33 (58%).
CONCLUSIONS.—
NA can be intermingled with high-grade UC, expanding the spectrum of entities that must be considered in the differential diagnosis, as it may mimic glandular or tubular differentiation, invasion, and a higher stage of disease. Misinterpretation of NA in such a setting may incorrectly convey a more aggressive biological potential of cancer to clinicians.
Topics: Male; Humans; Female; Aged; Urinary Bladder Neoplasms; Carcinoma, Transitional Cell; Carcinoma, Papillary; Carcinoma in Situ; Urothelium; Adenocarcinoma, Clear Cell; Adenoma
PubMed: 35976666
DOI: 10.5858/arpa.2021-0620-OA -
American Journal of Clinical Pathology Mar 1992Three cases of an unusual neoplasm of the lung appeared as solitary, peripheral pulmonary nodules in asymptomatic patients. These well-circumscribed neoplasms were...
Three cases of an unusual neoplasm of the lung appeared as solitary, peripheral pulmonary nodules in asymptomatic patients. These well-circumscribed neoplasms were composed of distinctive papillae covered by uniform cuboidal to columnar cells; more solid areas often were present. Ciliated cells, epithelial mucin, and necrosis were not observed, and mitotic activity was absent. Terminal tight junctions and microvilli were present in the two cases studied ultrastructurally. One specimen contained lamellar bodies and apical cytoplasmic dense bodies. Another case stained positively for a Clara cell-specific antigen, although surfactant apoprotein was not detected by immunostaining in the three cases. All patients have been free of disease (at 11 to 108 months). Papillary adenoma is an uncommon, apparently benign, and morphologically distinctive neoplasm. The immunohistochemical and ultrastructural findings hint at an origin from type II pneumocytes or Clara cells.
Topics: Adult; Cystadenoma; Humans; Immunoenzyme Techniques; Lung Neoplasms; Microscopy, Electron; Middle Aged
PubMed: 1543163
DOI: 10.1093/ajcp/97.3.393 -
Diagnostic Pathology Oct 2015Pulmonary papillary adenoma is a very rare tumor usually presenting in periphery of the lung. Herein, we present a case of pulmonary papillary adenoma located in central...
Pulmonary papillary adenoma is a very rare tumor usually presenting in periphery of the lung. Herein, we present a case of pulmonary papillary adenoma located in central portion of the lung in a 17 year-old Chinese female. A well-defined mass was incidentally detected at right pulmonary hilar region by imaging examination. Histologically, the tumor is predominantly composed of abundant papillary structures lined by columnar to cuboidal epithelial cells resembling type II pneumocytes. Immunohistochemical staining showed that the epithelial cells were diffusely positive for cytokeratin, cytokeratin7, TTF-1, EMA, surfactant apoprotein A, Napsin A, P63 and β-catenin. The Ki-67 proliferation index was approximately 2 %. Based on morphologic features and the immunohistochemical profile, the tumor was consistent with pulmonary papillary adenoma. Thus, it should be noted that pulmonary papillary adenoma was also a possible diagnosis for a central mass.
Topics: Adenoma; Adolescent; Biomarkers, Tumor; Biopsy; Female; Humans; Immunohistochemistry; Lung Neoplasms; Pneumonectomy; Treatment Outcome
PubMed: 26474555
DOI: 10.1186/s13000-015-0425-7 -
Gastrointestinal Endoscopy Apr 2016
Topics: Adenoma; Ampulla of Vater; Carcinoma in Situ; Common Bile Duct Neoplasms; Duodenoscopy; Endosonography; Humans; Male; Middle Aged; Neoplasm Recurrence, Local
PubMed: 26477935
DOI: 10.1016/j.gie.2015.10.007 -
Annals of Surgery Dec 1971
Topics: Adult; Aged; Colonic Neoplasms; Cystadenoma; Female; Humans; Lymphatic Metastasis; Male; Methods; Middle Aged; Neoplasm Metastasis; Pennsylvania; Rectal Neoplasms; Sutures
PubMed: 5132429
DOI: 10.1097/00000658-197112000-00020 -
Pathology, Research and Practice Jul 2017Nephrogenic adenoma is an uncommon benign lesion that occurs at several sites in urinary tract, from the renal pelvis to urethra, with the highest frequency in urinary... (Review)
Review
BACKGROUND
Nephrogenic adenoma is an uncommon benign lesion that occurs at several sites in urinary tract, from the renal pelvis to urethra, with the highest frequency in urinary bladder. Nephrogenic adenoma displays a broad spectrum of architectural and cytological features. Hence, recognition of its characteristic histopathological features is needed to distinguish this lesion from its mimickers.
MATERIALS AND METHODS
A retrospective series of 21 cases of nephrogenic adenoma in 18 patients, which were diagnosed in our department between 2010 and 2016, were analyzed. All histological slides were reviewed by two pathologists and the diagnosis of each case was confirmed. Immunohistochemistry was performed for PAX-8 in all cases. CK7, PAX-2, PSA, p53, p63, GATA-3 and α-methylacyl-CoA racemase (AMACR) were applied in problematic cases.
RESULTS
The most common location of the lesion was urinary bladder (14 patients) followed by renal pelvis (2 patients), ureter (1 patient) and urethra (1 patient). A history of urothelial carcinoma and repeated TUR procedures were observed in 12 patients. There were 2 pediatric patients aged 3 years. Both of them had undergone previous urosurgery because of megaureter in one and bladder exstrophy in the other. Other clinical antecedents included bladder diverticulum (1 patient), cystitis (1 patient) and nephrolithiasis (1 patient). Recurrence of lesion was seen in two patients (once in one case and twice in the other one). The median time to disease recurrence in these patients was 11 months (range, 2-20 months). Histologically, the lesions exhibited various morphological findings, with mixed (15 cases, 71.4%), pure tubular (3 cases, 14.3%), pure papillary (2 cases, 9.5%) and pure flat (1 case, 4.8%) growth patterns. Of the 15 cases with mixed patterns, 8 cases were tubulocystic and flat, 3 cases were tubular and flat, 2 cases were tubular, papillary and flat, 1 case was tubulocystic, papillary and flat, and 1 case was tubular and papillary. Flat pattern was observed in 15 cases (71.4%). It was seen in association with other patterns in 14 cases (mixed morphology) and purely in 1 case. Our findings suggested that the flat pattern is a frequent finding in nephrogenic adenomas. Notably one case in this series showed superficial extension into bladder muscularis propria.
CONCLUSIONS
Histologically nephrogenic adenoma may simulate a variety of malignancies. Awareness of characteristic morphologic features of nephrogenic adenoma is needed to diagnose this lesion correctly.
Topics: Adenoma; Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Biopsy; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Predictive Value of Tests; Retrospective Studies; Time Factors; Treatment Outcome; Turkey; Urologic Neoplasms; Young Adult
PubMed: 28554748
DOI: 10.1016/j.prp.2017.03.001 -
The American Journal of Surgical... Jun 2000In 1987 a clinicopathologic study by the Armed Forces Institute of Pathology (AFIP) of rare sweat gland tumors, termed aggressive digital papillary adenoma and... (Comparative Study)
Comparative Study
In 1987 a clinicopathologic study by the Armed Forces Institute of Pathology (AFIP) of rare sweat gland tumors, termed aggressive digital papillary adenoma and adenocarcinoma, was published. Since that time, the AFIP has continued to collect these tumors for study. Based on additional follow-up data, we think the original classification of these tumors requires revision. Sixty-seven cases of aggressive digital papillary adenoma and adenocarcinoma were studied according to their clinical characteristics and histologic features. Fifty of these were originally diagnosed as adenoma and 17 as adenocarcinoma. Follow up on 45 (67%) of the patients was obtained. None of the clinical or histologic parameters studied were found to be predictive of recurrence or metastasis, indicating that the originally proposed criteria for distinguishing between benign (adenoma) and malignant (adenocarcinoma) do not predict biologic behavior. When primary tumors were treated by subsequent reexcision or amputation, only one recurred (5%), when not so treated, 11 recurred (50%) regardless of the original diagnosis (p <0.05). Metastasis occurred in six (14%) cases and in three cases led to the death of the patient. Three of these metastatic cases had met the earlier criteria for adenoma. Pulmonary metastases were observed in five cases. No effective treatment for widespread metastatic disease has yet been developed. Because histologic features with prognostic significance could not be demonstrated in this retrospective review, we propose that all aggressive digital papillary tumors be designated aggressive digital papillary adenocarcinoma.
Topics: Adenocarcinoma, Papillary; Adenoma; Adult; Aged; Aged, 80 and over; Carcinoma, Skin Appendage; Data Interpretation, Statistical; Eccrine Glands; Female; Follow-Up Studies; Humans; Male; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Prognosis; Retrospective Studies; Sweat Gland Neoplasms; Sweat Glands; Terminology as Topic; Time Factors
PubMed: 10843279
DOI: 10.1097/00000478-200006000-00002 -
Clinical Radiology May 1979In presenting five new cases of renal adenomas the authors describe the general nature of these rare tumours. If the small adenoma corresponding to microscopic forms is...
In presenting five new cases of renal adenomas the authors describe the general nature of these rare tumours. If the small adenoma corresponding to microscopic forms is frequent, the large adenoma is rare and always solitary. Haematuria and pain are the most common signs. The classic criterion of non-malignancy in a solid tumour measuring less than 3 cm has no diagnostic value. From a review of the lieterature on the subject, the authors demonstrate the angio-architecture corresponding to the different types of adenoma: the tubular adenoma which is hypervascularised and well circumscribed; the papillary adenoma, often cortical, hypovascular or avascular with bordering arcade; the alveolar adenoma; the mixed forms. They stress the difficulty of radiological diagnosis and the frequency of transitional forms with cancer. The place of angiography is in the pre-operative diagnostic assessment and in defining localised anomalies in angio-architecture which can guide histological examination in the search for neoplastic foci.
Topics: Adenoma; Cystadenoma; Humans; Kidney Neoplasms; Male; Middle Aged; Radiography; Renal Artery
PubMed: 455910
DOI: 10.1016/s0009-9260(79)80100-2