An immunophenotypic comparison of metanephric metaplasia of Bowman capsular epithelium with metanephric adenoma, Wilms tumor, and renal development: a case report and review of the literature.
Metanephric metaplasia of the parietal epithelium of the Bowman capsule is a rare pathologic finding of unknown pathogenesis that has occurred in patients with widespread malignant neoplasms of various types. We report this finding in a 25-year-old woman with partial expression of the Carney triad who died of a disseminated gastrointestinal stromal tumor, specifically a gastric stromal sarcoma. The metaplasia involved both kidneys diffusely. It originated in the parietal epithelium of the Bowman capsule, extended into the proximal tubules, and focally surrounded the glomeruli in a semicircular manner Immunohistochemical analysis revealed that the cells of metanephric metaplasia expressed the Wilms tumor gene product, bcl-2 protein, and CD57 and cytokeratin 7 and keratin AE1/AE3 focally, but not CD56. This immunophenotype parallels that of metanephric adenoma, Wilms tumor, and nephrogenic rests and overlaps with antigen expression in certain periods of renal development.
Fischer
Edgar G
EG
Department of Laboratory Medicine, Mayo Foundation, Rochester, MN 55905, USA.
Carney
J Aidan
JA
Anderson
Scott R
SR
Klatt
Edward C
EC
Lager
Donna J
DJ
D000236:Adenoma / Q000378:metabolism / Q000473:pathology*; D000328:Adult; D004848:Epithelium / Q000378:metabolism / Q000473:pathology; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D007668:Kidney / Q000254:growth & development; D007680:Kidney Neoplasms / Q000378:metabolism / Q000473:pathology*; D008679:Metaplasia / Q000378:metabolism / Q000473:pathology; D009378:Neoplasms, Multiple Primary / Q000473:pathology*; D012509:Sarcoma / Q000473:pathology; D009396:Wilms Tumor / Q000378:metabolism / Q000473:pathology*