Cytopathology and Histopathology

Biography

Biography: Manjit Singh Bal

Abstract

Though ultrasound and CT have improved the diagnosis of renal lesions, explorations for a presumptive diagnosis of renal cell carcinoma (RCC) has to be done and are found to have other pathology. Histopathological examination of nephrectomies is of utmost importance for confirming the pre-operative diagnosis, typing of cancer.

Nephrectomy is the surgical removal of a diseased or damaged kidney. Simple nephrectomy is done for transplant purpose. Radical nephrectomy involves removal of a kidney, a part of the ureter, adrenal gland and fatty tissues surrounding the kidney.  Nephrectomy is indicated

• Non-functioning or very poorly functioning hydronephrotic, infected, ischemic, stone-containing-kidney with a normal kidney on the other side. 
• Malignant neoplasm of kidney i.e. Renal Cell Carcinoma, Nephroblastoma, Transitional Cell Carcinoma.
• Renal Tuberculosis/actinomycosis with resistant organisms involving the whole of the Adult Polycystic Kidney disease.
• Severely Traumatic Kidney.
• Congenital abnormalities of Kidney.
• Harvesting of the kidney from a Kidney Donor.

This paper is based on the histopathological analysis of lesions of a kidney in fifty nephrectomies received in the Department of Pathology at Government Medical College Patiala (India). Of the total cases, 40% were neoplastic and 60% were non-neoplastic. Neoplasms include two benign lesions (Renal Hemangioma & Renal Papillary adenoma, one case each); eighteen cases of malignant tumours i.e. RCC-11, Nephroblastoma-3, TCC-3 & Metastatic-1.

Non-Neoplastic lesions (30) were Chronic Pyelonephritis-26, Xanthogranulomatous CPN-1, Tuberculosis-1, Renal Amoebic abcess-1 and Traumatic Kidney-1.

Gross and microscopic findings were critically observed and recorded. We observed that nephrectomy could be avoided in benign lesions.