PURPOSE: This study aimed to identify non-neoplastic pathologic changes in partial nephrectomy specimens of patients without a known history of medical comorbidities. Routine analysis of this tissue may allow the clinician to identify subclinical renal disease. METHODS: We retrospectively reviewed our database of patients who underwent open partial nephrectomy for a small renal mass. Non-neoplastic tissue of partial nephrectomy specimens of patients without a known history of chronic kidney disease, diabetes mellitus, hypertension, or coronary artery disease was evaluated for glomerular, interstitial, and vascular pathologic changes. RESULTS: A rim of non-neoplastic tissue was adequate for pathologic evaluation in 91.8% of specimens. A total of 45 patients were studied with a median age of 52.0 years. Atherosclerosis was the most commonly identified pathologic finding in 9 (20%) patients, followed by mesangial expansion and interstitial fibrosis, each found in 8 (17.8%) patients. Linear regression found interstitial fibrosis to be the only pathologic lesion associated with preoperative serum creatinine (coefficient = 0.697, P = 0.001). Male gender was also associated with a higher preoperative creatinine (coefficient = 0.270, P = 0.034). Postoperative serum creatinine was not associated with any of the examined lesions. CONCLUSIONS: Current surgical techniques provide adequate non-neoplastic tissue for pathologic evaluation. We observed a striking degree of pathologic disease in patients without a known history of medical comorbidities. Routine inspection of the non-neoplastic parenchyma of partial nephrectomy specimens should be performed as it can alert the clinician to presence subclinical renal disease allowing for medical intervention.
PURPOSE: This study aimed to identify non-neoplastic pathologic changes in partial nephrectomy specimens of patients without a known history of medical comorbidities. Routine analysis of this tissue may allow the clinician to identify subclinical renal disease. METHODS: We retrospectively reviewed our database of patients who underwent open partial nephrectomy for a small renal mass. Non-neoplastic tissue of partial nephrectomy specimens of patients without a known history of chronic kidney disease, diabetes mellitus, hypertension, or coronary artery disease was evaluated for glomerular, interstitial, and vascular pathologic changes. RESULTS: A rim of non-neoplastic tissue was adequate for pathologic evaluation in 91.8% of specimens. A total of 45 patients were studied with a median age of 52.0 years. Atherosclerosis was the most commonly identified pathologic finding in 9 (20%) patients, followed by mesangial expansion and interstitial fibrosis, each found in 8 (17.8%) patients. Linear regression found interstitial fibrosis to be the only pathologic lesion associated with preoperative serum creatinine (coefficient = 0.697, P = 0.001). Male gender was also associated with a higher preoperative creatinine (coefficient = 0.270, P = 0.034). Postoperative serum creatinine was not associated with any of the examined lesions. CONCLUSIONS: Current surgical techniques provide adequate non-neoplastic tissue for pathologic evaluation. We observed a striking degree of pathologic disease in patients without a known history of medical comorbidities. Routine inspection of the non-neoplastic parenchyma of partial nephrectomy specimens should be performed as it can alert the clinician to presence subclinical renal disease allowing for medical intervention.
Authors: John R Srigley; Mahul B Amin; Brett Delahunt; Steven C Campbell; Anthony Chang; David J Grignon; Peter A Humphrey; Bradley C Leibovich; Rodolfo Montironi; Andrew A Renshaw; Victor E Reuter Journal: Arch Pathol Lab Med Date: 2010-04 Impact factor: 5.534
Authors: Elias A Castilla; Louis S Liou; Neil A Abrahams; Amr Fergany; Lisa A Rybicki; Jonathan Myles; Andrew C Novick Journal: Urology Date: 2002-12 Impact factor: 2.649
Authors: N Y Piper; J T Bishoff; C Magee; J M Haffron; R C Flanigan; A Mintiens; H P Van Poppel; I M Thompson; W J Harmon Journal: Urology Date: 2001-12 Impact factor: 2.649
Authors: Michael A Gorin; Michael Garcia-Roig; Monica Garcia-Buitrago; Carlos Parra-Herran; Merce Jorda; Gaetano Ciancio Journal: World J Urol Date: 2012-11-28 Impact factor: 4.226
Authors: Laura E Geldmaker; Amanda E Kahn; Kevin A Parikh; Ivan E Porter; Daniela A Haehn; Essa M Bajalia; Qihui Zhai; Colleen T Ball; David D Thiel Journal: Front Surg Date: 2021-04-16
Authors: Johannes Philipp Kläger; Ahmad Al-Taleb; Mladen Pavlovic; Andrea Haitel; Eva Comperat; Harun Fajkovic; Željko Kikić; Renate Kain; Nicolas Kozakowski Journal: J Nephrol Date: 2021-04-22 Impact factor: 3.902