Histomorphological Study of Renal Tumours – A Single Centre Experience

BACKGROUND Renal tumours encompass a wide spectrum as distinct entities both in adults and in children. Renal cell carcinomas constitute majority of all renal neoplasms. Proper typing of renal tumours is not possible before surgery and histopathological examination. Accurate histopathological diagnosis and proper tumour typing is very important for early and proper surgical treatment. We wanted to study the various histomorphological patterns of renal tumours. METHODS We studied nephrectomy specimens with renal tumours received in the department of pathology from January 2018 to June 2020 (2 years 6 months, retrospective study). A total of 29 cases with renal tumours were included. Relevant Clinical details along with gross findings were recorded from the histopathology forms. Nephrectomy specimens were fixed overnight in 10 % formalin. Gross examination was done, representative tissue bits taken, routinely tissue processed, embedded and the sections were cut (4 – 5 microns). Haematoxylin and Eosin staining was done. Pathological diagnosis was done by two pathologists and arrived at a common consensus. RESULTS A total of 29 cases were included in our study. Of these 16 patients were male and 13 were female, with a male to female ratio of 1.2: 1. Most common age group affected was 5th decade. Mean age was 48 years. Out of 29 cases, 24 cases were malignant (82.75 %) and 5 cases were benign (17.24 %). Renal cell carcinoma (RCC) accounted for 18 cases out of 24 malignant tumours. Clear cell RCC was common subtype with 13 cases followed by 3 cases of chromophobe RCC and 2 cases of papillary RCC. In benign tumours, we had 4 cases of angiomyolipoma and 1 case of oncocytoma. Right sided kidney was affected with 17 cases (58.62 %) and left sided kidney 12 cases (41.7 %). Common tumour location was in upper pole. Pathological stage pT1 was seen in 9 cases followed pT2-5 cases, pT3-4 and pT4-2 cases. WHO / ISUP nuclear grading was noted. Grade II was seen in 11 cases followed by grade III seen in 4 cases. CONCLUSIONS Malignant renal tumours were most common than the benign tumours. Renal cell carcinoma was most common of the malignant tumours. Clear cell RCC was the most common subtype. Pathological stage pT1 was most common. Grade II was the most common grade. Proper histological typing, staging and grading are important for appropriate surgical treatment of renal tumours. KEYWORDS Renal Tumours, Renal Cell Carcinoma, Nephrectomy