Characterization of the Peritumoral Atrophic Band and Nonneoplastic Renal Parenchyma in Radical Nephrectomy Specimens. Am J Clin Pathol 2021 Oct 13;156(5):913-919
Date
06/03/2021Pubmed ID
34075420DOI
10.1093/ajcp/aqab048Scopus ID
2-s2.0-85118598075 (requires institutional sign-in at Scopus site)Abstract
OBJECTIVES: Pathologic evaluation of nonneoplastic renal parenchyma in nephrectomy specimens is important for identifying chronic kidney disease and diabetic nephropathy, but increasing utilization of partial nephrectomies has led to less-sampled nonneoplastic parenchyma. The sampled tissue is often composed predominantly of the peritumoral atrophic band (PAB) directly adjacent to the tumor. We sought to determine the characteristics of the PAB and whether it could be used to reliably assess kidney pathology, including diabetic nephropathy.
METHODS: We investigated 59 radical nephrectomies to determine the PAB characteristics, whether the PAB is representative of distant nonneoplastic parenchyma, and if diabetic nephropathy could be reliably detected in the PAB.
RESULTS: Mesangial sclerosis was detected within the PAB in 100% of cases with mesangial sclerosis in the distant parenchyma. Eighty percent had a history of diabetes. The PAB exhibited increased glomerular sclerosis (51% vs 13%, Pā <ā .001) and interstitial fibrosis and tubular atrophy (83% vs 13%, Pā <ā .001) compared with distant parenchyma.
CONCLUSIONS: Diabetic nephropathy can be reliably detected in the PAB, which is important in partial nephrectomies or renal mass biopsies without ample distant renal parenchyma. The degree of glomerular and tubulointerstitial scarring within the PAB does not reflect the overall degree of chronic kidney disease.
Author List
Dernell C, Bhasin B, Iczkowski KA, Gallan AJAuthor
Alexander J. Gallan MD Assistant Professor in the Pathology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Diabetic Nephropathies
Female
Humans
Kidney
Kidney Neoplasms
Male
Middle Aged
Nephrectomy