Histomorphological Spectrum of Nephrectomy Specimens with Special Reference to Renal Cell Carcinoma: A ten year Institutional Study from Central India

Background: Nephrectomy is done in various non-neoplastic lesions such as chronic pyelonephritis (CPN) and in neoplastic lesions such as renal cell carcinoma (RCC) and Wilm’s tumor. Renal cell carcinoma has many prognostic factors like tumor size, venous invasion, perinephric fat invasion, adrenal involvement, tumor grade, RCC subtype, tumor necrosis, and lymph node and distant metastasis which can easily be assessed by detailed morphologic examination of nephrectomy specimens. Objectives: To study the demographic and clinico-histopathological features of nephrectomy specimens. Materials and methods: This was a cross-sectional observational study done for a period of ten years. It included all nephrectomy specimens except autolyzed specimens and renal biopsy. The clinical and demographic data with detailed gross and microscopic features of all specimens were noted and analyzed. Results: Out of a total of 100 nephrectomy specimens 45 % were non-neoplastic and 55% were neoplastic. Left nephrectomy specimens were 74 %. Male to female ratio was 1.2:1. Age range was 11 months to 80 yrs. RCC was the most common neoplastic lesion with the clear cell variant as the commonest subtype. The mean size of RCC was 14.3 cm. The capsular invasion, vascular invasion, and extension to perinephric fat were observed in 10/55 (18%), 8/55 (14.5%), and 6/55 cases (10.9%) respectively. Conclusion: Nephrectomy is indicated in a wide variety of lesions. A detailed morphological examination is necessary for each specimen for accurate diagnosis, staging, and grading of tumor which helps in the proper management of patient.