Morphological and Histological Features of Nephrectomy Materials: A Single-Center Experience and Short Review of the Literature

Abstract

Objective: To determine the demographic characteristics of patients undergoing nephrectomy at a tertiary care hospital and to analyze the spectrum of renal tumors based on histopathological findings of nephrectomy specimens by current literature. Material and Method: The results of nephrectomy materials admitted to the pathology clinic between January 2019 and December 2023 were included in the study. The demographic characteristics of the included patients, presenting complaints, reasons for nephrectomy, surgical method, nephrectomy area, tumor dimension, and histopathological reports were recorded in a standard data form. Results: A total of 325 nephrectomy materials were included in the study. 61.5% of the patients were male. The mean age of the patients was 54.5±20.2 years (min:3 max:91). The most common presenting complaints were flank pain (28.3%). The most commonly observed pathological malignancy was clear cell carcinoma (32%), and it was found to be significantly higher in male patients (38.5%) (p=0.001). The most frequently detected pathological TNM grade of the patients was grade 1, and the histological WHO/ISUP grade was 2. 28.9% of the patients (n:94) received a diagnosis incidentally. Among those incidentally diagnosed patients, 87.2% (n:82) were histopathologically malignant. When benign pathological diagnoses were examined, the most common diagnosis was pyelonephritis, followed by oncocytoma, benign cystic disease, and angiomyolipoma, respectively. Conclusion: According to our study results, malignant tumors are more commonly observed than benign neoplasms. Despite advancements in imaging technologies, the histopathological diagnosis of renal masses cannot be determined preoperatively, and surgical intervention is required for diagnosis

Keywords

• Nephrectomy
• tumor
• histopathology
• clear cell carcinoma
• oncocytoma
• and pyelonephritis

Nefrektomi Materyallerinin Morfolojik ve Histolojik Özellikleri: Tek Merkez Deneyimi ve Literatürün Kısa Gözden Geçirilmesi

Abstract

Amaç: Üçüncü basamak bir hastanede nefrektomi yapılan hastaların demografik özelliklerini belirlemek ve güncel literatür doğrultusunda nefrektomi örneklerinin histopatolojik bulgularına dayanarak böbrek tümörleri spektrumunu analiz etmek. Gereç ve ve Yöntem: Çalışmaya Ocak 2019 ile Aralık 2023 tarihleri arasında patoloji kliniğine başvuran nefrektomi materyallerinin sonuçları dahil edildi. Çalışmaya dahil edilen hastaların demografik özellikleri, başvuru şikayetleri, nefrektomi nedenleri, cerrahi yöntem, nefrektomi bölgesi, tümör boyutu ve histopatolojik raporları standart bir veri formuna kaydedildi. Bulgular: Çalışmaya toplam 325 nefrektomi materyali dahil edildi. Hastaların %61,5’i erkekti. Hastaların ortalama yaşı 54,5±20,2 yıl (min:3 max:91) idi. En sık başvuru yakınması yan ağrısı (%28,3) idi. En sık görülen patolojik malignite berrak hücreli karsinom (%32) olup, erkek hastalarda (%38,5) anlamlı olarak daha yüksek olduğu görüldü (p=0,001). Hastaların en sık saptanan patolojik TNM derecesi derece 1, histolojik WHO/ISUP derecesi ise 2 idi. Hastaların %28,9’una (n:94) tesadüfen tanı konuldu. Tesadüfen tanı konulan hastaların %87,2’si (n:82) histopatolojik olarak malign idi. Benign patolojik tanılar incelendiğinde en sık görülen tanı piyelonefrit olup, bunu sırasıyla onkositoma, benign kistik hastalık ve anjiyomiyolipom izlemektedir. Sonuç: Çalışmamızın sonuçlarına göre malign tümörler benign neoplazmlara göre daha sık görülmektedir. Görüntüleme teknolojilerindeki ilerlemelere rağmen böbrek kitlelerinin histopatolojik tanısı ameliyat öncesi net olarak belirlenememekte ve tanı için cerrahi müdahale gerekmektedir.

Keywords

• Nefrektomi,
• tümör,
• histopatoloji,
• berrak hücreli karsinom,
• onkositoma
• piyelonefrit

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