Initial Neoplastic Proliferations and Background Pathologies of Kidneys with Clear Cell Renal Carcinoma

Introduction. Nephrosclerosis and development of renal tumours is desribed in literature. But there is a few dates about correlation between grades of nephrosclerosis and renal tumours. Aim of the study. Aim of our study is to find out and to analyze initial neoplastic proliferation around renal cell carcinoma in case of nephrosclerosis of different degrees. The hypothesis: the initial neoplastic proliferation in renal cell carcinoma is related to the degree of nephrosclerosis. Materials and methods. We investigated 206 surgical removed kidneys with clear cell renal carcinoma (RCCC) cases. To evaluate the correlation between grading of RCCC and its stages with nephrosclerosis we framed 5 macroscopic degrees of its severity. According the expression of nephrosclerosis we analyzed microscopically renal tissue to diagnose initial neoplastic proliferations. Results. In our research we have got weak positive correlation of R = 0.2 (p = 0.01) between nephrosclerosis and grading of renal clear cell carcinoma. Practically the same correlation exists between renal tumor TNM stage and nephrosclerosis degrees. In 62 cases from all 206 examined surgically removed kidneys microscopically and grossly we have diagnosed initial neoplastic proliferations. Histological variations of them were: papillary adenoma, oncocytoma, nephrogenic adenoma and clear cell proliferations. Accordingly the localization of these neoplastic proliferations we can divide them into subcapsular, cortical and medullar both in the tumour capsule and outside it. Around the neoplastic proliferations we have evaluated the intensity of inflammation, arteriosclerosis, glomerulosclerosis, cystic transformations of renal tubules and stromal fibrosis. Conclusions. We have proved that the most marked correlation was between the background pathologies and papillary adenoma (n = 29). More common the diameter of fibrosis was several times larger than the size of adenoma. There was also strong correlation with cystic changes of renal tubules. There is a correlation R = 0.305 (p = 0.01) between the frequency of papillary adenoma findings and of nephrosclerosis stages. The second most common initial neoplastic proliferation was clear cell proliferations (n = 26). But it has less pronounced association with the background changes. We have not proved the correlation between the frequency of renal clear cell carcinoma and severity of nephrosclerosis.