Morphological and Immunohistochemical Characteristics of Surgically Removed Paediatric Renal Tumours in Latvia (1997-2010)

Open access

Morphological and Immunohistochemical Characteristics of Surgically Removed Paediatric Renal Tumours in Latvia (1997-2010)

Introduction. Paediatric renal tumours represent 7% of all childhood malignancies. The variable appearances of the tumours and their rarity make them especially challenging group of lesions for the paediatric pathologist. In Latvia diagnostics and treatment of childhood malignancies is concentrated in Children's Clinical University Hospital. Microscopic evaluation of them is realised in Pathology office of this hospital.

Aim of the study is to analyze morphologic spectrum of children kidney tumours in Latvia and to characterise them from modern positions with wide range of immunohistochemical markers using morphological material of Pathology bureau of Children's Clinical University Hospital.

Materials and methods. We have analyzed surgically removed primary renal tumours in Children Clinical University Hospital from the year 1997 till 2010. Samples were fixed in 10% formalin fluid, imbedded in paraffin and haematoxylin-eosin stained slides were re-examined. Immunohistochemical re-investigation was made in 65.91% of cases. For differential diagnostic purposes were used antibodies for the detection of bcl-2, CD34, EMA, actin, desmin, vimentin, CKAE1/AE3, CK7, Ki67, LCA, WT1, CD99, NSE, chromogranin, synaptophyzin, S100, myoglobin, miogenin, MyoD1 (DakoCytomation) and INI1 protein (Santa Cruz Biotechnology).

Results. During the revised period there were diagnosed 44 renal tumours. Accordingly of morphological examination data neoplasms were divided: 1) nephroblastoma - 75%, 2) clear cell sarcoma - 2.27%, 3) rhabdoid tumour - 4.55%, 4) angiomyolipoma - 4.55%, 5) embrional rhabdomyosarcoma - 2.27%, 6) mesoblastic nephroma - 4.55%, 7) multicystic nephroma - 4.55%, 8) angiosarcoma - 2.27%. Immunohistochemical investigation specify the diagnosis in 4.55% of patients. In case of embryonal rhabdomyosarcoma we found that immunophenotype is more typical for cellular mesoblastic nephroma (infantile renal fibrosarcoma) but one neuroblastoma was misdiagnosed as nephroblastoma.

Conclusions. 1. The most common childhood renal tumours in Latvia like in the world is nephroblastoma. 2. In Latvia there are diagnosed such rare pediatric tumours as clear cell sarcoma and rhabdoid tumour; amount of first one is like in the world, but rhabdoid tumour was more common in Latvia then in the world. 3. No cases of renal cell carcinoma was diagnosed under age of 18 what differs from the data of the world. 4. The results of our investigations proved that immunohistochemical analytic schemes for blastemal type nephroblastoma and mesenchymal kidney tumours in our hospital should be extend but for the precise diagnosis of rhabdoid tumour of kidney would be recommended cooperation between laboratories of several countries for the detection of INI1 protein expression.

  • Ahmed HU, Arya M, Levitt G, Duffy PG, Mustaq I, Sebire NJ. Part II: Treatment of primary malignant non-Wilms' renal tumours in children // Lancet Oncol, 2007; 8:842-8

  • Argani P. Rhabdoid tumor. // In: Eble JN, Sauter G, Epstein JI & Sesterhenn A. Isabell. World Health Organization Classification of Tumours Pathology & Genetics, Tumours of the Urinary System and Male Genital Organs, Lion: IARC Press 2004, 58-59

  • Argani P, Perlman EJ, Breslow NE, Brovning NG, Green DM, D'Angio GJ, Beckwith JB. Clear cell sarcoma of the kidney: a review of 351 cases from the National Wilms Tumor Study Group Pathology Center // Am J Surg Pathol, 2000; 24:4-18

  • Argani P, Sorensen PHB. Congenital mesoblastic nephroma // In: Eble JN, Sauter G, Epstein JI & Sesterhenn A. Isabell. World Health Organization Classification of Tumours Pathology & Genetics, Tumours of the Urinary System and Male Genital Organs, Lion: IARC Press 2004, 60-61

  • Barnoud R, Sabourin JC, Pasquier D, Ranchere D, Bailly C, Terier-Lacombe MJ, Pasquer B. Immunohistochemical expression of WT1 by desmoplastic small round cell tumor: a comparative study with other small round cell tumors // Am J Surg Pathol, 2000; 24: 830-6

  • Birch JM, Breslow N. Epidemiologic features of Wilms' tumor // Hematol Oncol Clin North Am, 1995; 9:1157-78

  • Coffin CM, Belchis D. Immunohistology of pediatric neoplasms // In: Dabbs JD. Diagnostic Immunohistochemistry, 2st ed. Philadelphia: Churchill Livingstone Elsevier; 2006; 611-630

  • Eble JN, Young RH. Mesenchymal tumors of the kidney // In: Fletcher CDM. Diagnostic Histopathology of Tumors, 3st ed. Philadelphia: Churchill Livingstone Elsevier 2007, 502-510

  • Gladell PP, Turk TM, Clark JI, Lindgren V, Picken PP. Passive seeding in metanephric adenoma. A review of psuedometastatic lesions in perinephric lymph nodes // Arch Pathol Lab Med, 2005; 129: 1317-1321

  • Grignon DJ, McIsaac GP, Armstrong RF, Wyatt JK. Primary rhabdomyosarcoma of the kidney, a light microscopic, immunohistochemical, and electron microscopic study // Cancer, 1998; 62:2027-32

  • Jankauskiene A, Drustė- Kurilavičienė S, Puzinas A. Nephrectomy to children (in lithuanian) // Medicinos teorija ir praktika, 2009; 71-75

  • Kokashi K, Oda Y, Nakamori M, Yamamoto H, Tamiya S, Toubo T, Kinoshita Y, Tajiri T, Taguchi T, Tsuneyoshi M. Multifocal metanephric adenoma in childhood // Pathol Int, 2009; 59(1): 49-52.

  • Perlman EJ. Pediatric renal tumours: practical updates for the pathologist // Pediatr Dev Pathol, 2005; 8: 320-338

  • Perry A, Fuller EC, Judkins AR, Dehner LP, Biegel JA. INI1 expression is retained in composite rhabdoid tumors, including rhabdoid meningiomas // Mod Pathol, 2005; 18: 951-958

  • Sebire JN. Renal pathology // In: Sebire JN, Malone M, Answorth M, Jacques TS. Diagnostic Pediatric Surgical Pathology. 1st ed. Philadelphia: Churchill Livingstone Elsevier; 2010; 1-103

  • Sebire JN, Vujanic GM. Paediatric renal tumors: recent development, new entities and pathological features // Histopathology, 2009; 54:516-28

  • Shao L, Hill DA, Perlman EJ. Expression of WT-1, Bcl-2 and CD34 by primary renal spindle cell tumors in children // Pediatr Dev Pathol, 2004; 7:577-82

  • van den Heuvel-Eibrink MM, van Tinteren H, Rehorst H, Colombe A, Patte C, de Camargo B, de Kraker J, Leuschner I, Lutenberg R, Pritchard-Jones K, Sandset B, Spreafico F, Vujanic GM. Malignant rhabdoid tumours (MRTKs) registered on recent SIOP protocols from 1993 to 2005: A report of the SIOP renal tumour study group // Pediatr Blood Cancer, 2011; 56: 733-737

  • Vujanic GM, Sandsted B, Harms D, Boccon-Gibod L, Delemarre JF . Rhabdoid tumour of the kidney: a clinicopathological study of 22 patients from the International Society of Paediatric Oncology (SIOP) nephroblastoma file // Histopathology, 1996; 28:333-40

  • Weeks DA, Beckwith JB, Mierau GW, Zuppan CW. Renal neoplasms mimicking rhabdoid tumor of kidney. A report from the National Wilms' Tumor Study Pathology Center // Am J Surg Pathol, 1991; 15: 1042-54

  • Whittle S, Gosain A, Brown PYS, Debelenko L, Raimondi S, Wilimas JA, Jenkins JJ, Davidoff AM. Brief report Regression of a congenital mesoblastic nephroma // Pediatr Blood Cancer, 2010; 55: 364-368

Acta Chirurgica Latviensis

The Journal of Riga Stradins University; Latvian Association of Surgeons; Latvian Association of Paediatric Surgeons

Journal Information


All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 7 7 7
PDF Downloads 1 1 1