title: Benign mesenchymal tumours and tumour-like lesions in end-stage renal disease.
abstract: OBJECTIVE
  Mesenchymal neoplasms of the kidney are rare, and most represent sporadic angiomyolipomas. A few haemangiomas have been reported in end-stage renal disease (ESRD) but, to date, no study has focused on the frequency and morphological spectrum of mesenchymal lesions in ESRD.
  
  
  RESULTS
  We evaluated retrospectively 90 nephrectomy specimens with ESRD. Haemangiomas were detected in eight cases (8.8%; six males and two females; mean age: 55 years); four were multifocal and four had concurrent renal epithelial neoplasms. Lesions involved the medulla (three), cortex (two) or both (three), and the size range was 1-25 mm (mean 4.8 mm). Histologically, all were capillary haemangiomas with an at least focally detectable spleen-like anastomosing pattern. All tumours stained positively for CD31 and FLI-1, but none expressed pankeratin (KL-1), podoplanin/D2-40, HHV8 or GLUT-1. Minute angiomyolipomas (mean size 2.3 mm) were detected in four patients (mean age 49.5 years). Tumour-like smooth muscle proliferations were seen surrounding muscular arteries (eight), occasionally admixed with fat extending from the renal sinus mimicking angiomyolipoma. No similar tumours were found in 105 control kidneys.
  
  
  CONCLUSIONS
  Benign haemangiomas are not uncommon in ESRD, but may be under-recognized. They display distinctive morphology and should be distinguished from angiosarcomas and capillary-rich renal cell carcinomas.
authors.affiliation: Institute of Pathology, Department of Nephropathology, University Hospital of Erlangen, Krankenhausstraße 8-10, Erlangen, Germany.
authors.forename: Maike
authors.initials: M
authors.lastname: Büttner
authors.forename: Verena
authors.initials: V
authors.lastname: Kufer
authors.forename: Kathrin
authors.initials: K
authors.lastname: Brunner
authors.forename: Arndt
authors.initials: A
authors.lastname: Hartmann
authors.forename: Kerstin
authors.initials: K
authors.lastname: Amann
authors.forename: Abbas
authors.initials: A
authors.lastname: Agaimy
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018207:Angiomyolipoma / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000378:metabolism; D002196:Capillaries / Q000473:pathology; D002292:Carcinoma, Renal Cell / Q000098:blood supply / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006391:Hemangioma / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D006394:Hemangiosarcoma / Q000175:diagnosis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D007680:Kidney Neoplasms / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008840:Microfilament Proteins / Q000378:metabolism; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D009392:Nephrectomy; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000378:metabolism; D018160:Receptors, Cytoplasmic and Nuclear / Q000378:metabolism; D012189:Retrospective Studies; D015534:Trans-Activators; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; C098179:FLII protein, human; D008840:Microfilament Proteins; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D018160:Receptors, Cytoplasmic and Nuclear; D015534:Trans-Activators