Maligniteyi Taklit Edebilen Nefrojenik Adenomların Klinikopatolojik Özellikleri

Öz

Nefrojenik adenom (NA), maligniteyi taklit edebilen çeşitli klinik ve histopatolojik özelliklere sahip, idrar yollarının nadir görülen benign bir lezyonudur. Bu çalışma, tek merkezli bir kohortta klinikopatolojik özellikleri, histolojik paternleri ve ilişkili durumları değerlendirmeyi; ayrıca tanısal açıdan karışabileceği diğer malign durumlarla ayırıcı tanıyı vurgulamayı amaçlamıştır. NA tanısı konulan 39 hastadan alınan 49 biyopsi örneği üzerinde retrospektif bir analiz yapılmıştır. Klinik veriler, sistoskopik bulgular kaydedilmiştir. Hastaların medyan yaşı 68 olup, erkeklerde daha sıktır (%76.9). En sık görülen belirtiler hematüri ve dizüri (%28.2) olmuştur. En sık etkilenen bölge mesane (%79.5) olmuştur. Histolojik olarak düz (%67.3) ve tübüler (%59.2) paternler baskın olup, vakaların çoğunda birden fazla birlikte görülen patern mevcuttu. Vakaların %71.8’inde eşlik eden neoplazi tespit edildi, en sık görülen ise invaziv ürotelyal karsinomdu (%53.8). Hastaların bir alt grubunda nüks meydana geldi. NA, belirgin histolojik heterojenite gösterir ve sıklıkla ürotelyal neoplazi ile birlikte görülmektedir. Çeşitli morfolojisinin ve malignite ile sık birlikte görülmesinin farkında olmak, tanısal tuzaklardan kaçınmak ve uygun klinik yönetimi sağlamak için önemlidir.

Anahtar Kelimeler

• Nephrogenic adenoma
• nephrogenic metaplasia
• fibromyxoid
• renal pelvis
• bladder

Destekleyen Kurum

Ondokuz Mayıs Üniversitesi Hastanesi

Etik Beyan

Bu çalışma, Ondokuz Mayıs Üniversitesi Hastanesi Kurumsal Etik Kurulu tarafından onaylanmıştır (protokol numarası 2026/242, onay tarihi: 29.04.2026) ve Helsinki Bildirgesi ilkelerine uygun olarak gerçekleştirilmiştir.

Clinicopathological Features of Nephrogenic Adenomas Mimicking Malignancy

Öz

Nephrogenic adenoma (NA) is a rare benign lesion of the urinary tract with diverse clinical and histopathological features that may mimic malignancy. This study aimed to evaluate the clinicopathological features, histological patterns, and associated conditions in a single-center cohort, and to emphasize the differential diagnosis from other malignant entities that may pose diagnostic challenges. A retrospective analysis was performed on 49 biopsy specimens from 39 patients diagnosed with NA. Clinical data, cystoscopic findings were recorded. The median patient age was 68 years, with a male predominance (76.9%). The most common presenting symptoms were hematuria and dysuria (28.2% each). The bladder was the most frequent site of involvement (79.5%). Histologically, flat (67.3%) and tubular (59.2%) patterns were predominant, and most cases exhibited multiple coexisting patterns. Accompanying neoplasia was identified in 71.8% of the cases, most commonly invasive urothelial carcinoma (53.8%). Recurrence occurred in a subset of patients. NA demonstrates marked histologic heterogeneity and  is frequently coexists with urothelial neoplasia. Awareness of its diverse morphology and frequent coexistence with malignancy is essential to avoid diagnostic pitfalls and ensure appropriate clinical management.

Anahtar Kelimeler

• Nefrojenik adenom
• nefrojenik metaplazi
• fibromiksoid
• renal pelvis
• mesane

Destekleyen Kurum

Ondokuz Mayıs University Hospital

Etik Beyan

. This study was approved by the Institutional Ethics Committee of Ondokuz Mayıs University Hospital (protocol number 2026/242, approval date: 29.04.2026) and was performed in accordance with the tenets of the Declaration of Helsinki.

Kaynakça

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