Renal glomerular alterations in patients with cancer: a clinical and immunohistochemical autopsy study.
BACKGROUND
Membranous glomerulonephritis (MGN) can be found in patients with cancer as a paraneoplastic syndrome or it could be manifested clinically before tumor detection. The aim of this study was to evaluate the frequency and type of renal histopathological alterations in patients with malignancy that died without cancer treatment and were submitted to necropsy.


METHODS
Patient's demographical and clinical data collection and laboratory tests (serum creatinine and urine sample) were evaluated.


RESULTS
Kidney fragments from 21 patients were obtained and studied by light microscopy after habitual staining. Immunohistochemistry studies were performed with monoclonal immunoglobulin and tumor markers. Patients' mean age was 71 years and 62% were male. The most frequent tumor was gastric cancer (five cases), followed by colon and oral cavity (three cases each). In 67% of the cases, malignancy was the main cause of death. Serum creatinine was increased in 10 cases, proteinuria in 15, and hematuria was present in 8 cases. The most usual glomerular lesion found was thickening of basement membrane (BM) of the capillary loops. There were two cases of IgA nephropathy, three cases of focal segmental glomerulosclerosis, and one case of MGN. Only in the patient with MGN and metastatic melanoma specific tumor markers were identified in the kidney.


CONCLUSIONS
We observed a wide range of glomerular pathological changes and abnormal urinary sediments in almost all patients, but we found tumor marker deposits only in the patient with MGN.
Faria
Tamara Veiga
TV
Department of Pathology, Faculdade de Medicina de São José do Rio Preto, São Paulo, Brazil. tamaraveiga@yahoo.com.br
Baptista
Maria Alice Ferreira
MA
Burdmann
Emmanuel A
EA
Cury
Patrícia M
PM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D014408:Biomarkers, Tumor / Q000378:metabolism; D002277:Carcinoma / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D005921:Glomerulonephritis / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007678:Kidney Glomerulus / Q000378:metabolism* / Q000473:pathology*; D008297:Male; D008545:Melanoma / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000378:metabolism / Q000473:pathology
D014408:Biomarkers, Tumor