Cystic nephroma: a histologic and immunohistochemical study of 10 cases.
BACKGROUND
Cystic nephroma is a rare and controversial benign multicystic renal tumor. While the clinical, radiologic, and histologic features of cystic nephroma are well described, the immunohistochemical features are not. The role of immunohistochemistry in the differential diagnosis, which includes multicystic renal cell carcinoma, is also unknown.


OBJECTIVE
To define the histologic and immunohistochemical features of cystic nephroma.


METHODS
Ten cases of cystic nephroma diagnosed at 2 institutions during a period of 10 years were stained with an immunohistochemical panel consisting of 20 immunostains.


RESULTS
Median age at diagnosis was 61 years, with a range from 31 to 79 years. The female-to-male ratio was 9:1. Grossly, the tumors were multicystic masses without solid nodules. Histologic features included cysts lined by flat, cuboidal, or hobnail epithelium and septa variably lined by fibrous (10/10 cases) and/or ovarian-like (7/10 cases) stroma. Corpus albicans-like acellular hyalinized structures were noted in the septa in 9 of 10 cases. The cyst epithelium showed consistent positivity for distal tubule/collecting duct markers (cytokeratin 19, cytokeratin AE1/AE3, epithelial membrane antigen) and variable positivity for proximal tubule markers (alpha1-antitrypsin, lysozyme, CD15, CD10). The ovarian-like stroma (present in 7/10 cases) stained positively for progesterone receptors (6/7 cases) and estrogen receptors (4/7 cases).


CONCLUSIONS
Our immunohistochemical findings confirm a previous report of both distal tubule/collecting duct and proximal tubule differentiation in cystic nephroma. Stromal estrogen and/or progesterone receptor positivity in the majority of cases of cystic nephroma is a novel finding.
Mukhopadhyay
Sanjay
S
Department of Pathology, State University of New York Upstate Medical University, Syracuse 13210, USA.
Valente
Alfredo Luis
AL
de la Roza
Gustavo
G
D000199:Actins / Q000276:immunology; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D002292:Carcinoma, Renal Cell / Q000175:diagnosis; D003537:Cystadenoma / Q000175:diagnosis*; D003893:Desmin / Q000276:immunology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000639:trends; D007680:Kidney Neoplasms / Q000175:diagnosis*; D007685:Kidney Tubules, Collecting / Q000737:chemistry / Q000473:pathology; D007687:Kidney Tubules, Proximal / Q000737:chemistry / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000737:chemistry / Q000473:pathology; D009418:S100 Proteins / Q000276:immunology; D014746:Vimentin / Q000276:immunology
D000199:Actins; D015415:Biomarkers; D003893:Desmin; D009418:S100 Proteins; D014746:Vimentin