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Cystic nephroma and mixed epithelial and stromal tumour of the kidney: opposite ends of the spectrum of the same entity
European Urology, 11/06/08

Montironi R et al. - In a review of the broad spectrum of usual and unusual clinical and morphologic findings observed in cystic nephroma (CN) and mixed epithelial and stromal tumour (MEST), it was pointed out that cystic nephroma and mixed epithelial and stromal tumour of the kidney have similarities. Differences are based on degree of solid growth and stromal cellularity. Renal epithelial and stromal tumour is an appropriate term to encompass findings observed in these neoplasms.

Methods

Based on Medline database searches, all aspects of CN and MEST were assessed.

Results

CN and MEST have a remarkable similarity in sex predilection, age distribution, and morphologic attributes of both epithelial and stromal components and immunohistochemical profile, albeit with variation in individual categories, with higher prevalence of stromal-to-epithelial ratio, prominent ovarian-like stroma, smaller cysts, and stromal luteinisation in MEST, and large cysts, thin septa, and low stromal-to-epithelial ratio in CN.
The stromal component in both lesions expresses estrogen and progesterone receptors.
Rare and unusual morphologic features, such as endometrioid, cervical, and intestinal differentiation, and luteinised ovarian-like stroma, have been described in MEST.
The epithelial element occasionally shows estrogen and progesterone receptors.
Rare aggressive behaviour has been reported for both neoplasms.

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