[Juxtaglomerular cell tumor of the kidney: a clinicopathologic analysis of five cases].
OBJECTIVE
To study the morphologic characteristics and immunophenotype of juxtaglomerular cell tumor of the kidney (JGCT), with discussion on its diagnostic clues and possible histogenesis.


METHODS
The clinical, pathologic and immunohistochemical features of 5 cases of JGCT were evaluated. In addition, 5 cases of hemangiopericytoma and 5 cases of cutaneous glomus tumor were selected for comparative immunohistochemical analysis.


RESULTS
The JGCT cases came from 4 females and 1 male (mean age at diagnosis = 32 years). All of them manifested symptoms of systemic hypertension. Four of the patients received partial nephrectomy and the remaining patient was treated by radial nephrectomy. All of them were followed up for a period of 4 to 66 months (average = 27 months). There was no evidence of local recurrence or distant metastases. On gross examination, these JGCTs were well-circumscribed and situated in the renal cortex and measured 4.4 cm in greatest dimension on average. Histologically, the tumor was characterized by the following three features: (1) solid sheets of relatively uniform polygonal to round cells with lightly eosinophilic cytoplasm, sometimes containing PAS-positive intracytoplasmic granules; (2) absence of or very scanty mitotic figures; (3) interstitium rich in thin-walled capillaries, associated with focal hyaline change and hemangiopericytoma-like architectural pattern. Under electron microscopy, characteristic rhomboid-shaped renin granules were found in the cytoplasm. All JGCTs were immunoreactive for renin, CD34, actin, and calponin. In contrast, all glomus tumors were negative for renin and all hemangiopericytomas were negative for actin.


CONCLUSIONS
JGCT is a rare benign renal neoplasm typically found in young adults and manifests as systemic hypertension. The tumor cells may be originated from modified vascular smooth muscle cells. The identification of renin granules by electron microscopy and demonstration of the characteristic immunophenotype is the key to correct pathologic diagnosis.
Ren
Guo-ping
GP
Department of Pathology, The First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou 310003, China. gpren1999@163.com
Yu
Xin-ru
XR
Li
Yong-xiang
YX
Wang
Li-jun
LJ
Wang
Jin-quan
JQ
Shi
Hong-qi
HQ
Ye
Hui-hui
HH
D000328:Adult; D018952:Antigens, CD34 / Q000032:analysis; D002135:Calcium-Binding Proteins / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007606:Juxtaglomerular Apparatus / Q000737:chemistry / Q000473:pathology* / Q000648:ultrastructure; D007633:Keratins / Q000032:analysis; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008840:Microfilament Proteins; D008854:Microscopy, Electron; D008875:Middle Aged; D000096985:Calponins
D018952:Antigens, CD34; D002135:Calcium-Binding Proteins; D007633:Keratins; D008840:Microfilament Proteins; D000096985:Calponins