Kidney tumor - cysts, children, adult benign
Cystic nonneoplastic lesions
Acquired cystic kidney disease

Authors: Mandolin Ziadie, M.D. (see Authors page)

Revised: 9 January 2017, last major update December 2011

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PubMed Search: acquired cystic kidney disease
Cite this page: Acquired cystic kidney disease. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/kidneytumoracquiredcyst.html. Accessed March 25th, 2017.
Definition / General
  • Three or more cysts per kidney in patients on longstanding hemo- or peritoneal dialysis for end stage renal disease (unrelated to underlying renal pathology)
Epidemiology
  • Occurs in 10% - 20% of patients within the first three years of dialysis, 50% within the first five years and 90% after ten years
  • Also occurs in patients with longterm uremia prior to dialysis
  • Males > females during first ten years of dialysis
  • Not restricted to adults; occurs in children and young adults on dialysis (Pediatr Nephrol 1997;11:447)
  • Frequency and severity not affected by online hemodiafiltration (Ren Fail 2009;31:555)
Pathophysiology
  • May be due to uremia
  • Cysts may form due to obstruction by oxalate crystals, fibrosis or hyperplasia
Clinical Features
Case Reports
Gross Description
  • Moderately enlarged kidneys (usually < 800 g) with cortical and medullary cysts containing clear fluid
  • > 40% replacement of kidney with cysts
Gross Images

Images hosted on other servers:

Left: acquired cystic disease; right: with renal cell carcinoma

Renal transplant 12 years prior

With central scar

Micro Description
  • Cysts lined by flattened or cuboidal epithelium that may show focal pseudopapillae with nuclear enlargement and loss of polarity
  • Cysts may contain oxalate crystals
  • Surrounding parenchyma shows global glomerulosclerosis, interstitial fibrosis and tubular atrophy
Micro Images

Images hosted on other servers:

Various images

Fig 2: atypical
papillary hyperplasia;
Fig 1 & 3: associated
carcinomas

Molecular / Cytogenetics Description
  • Atypical epithelial proliferations associated with gains of #7, #12, #17, #20 and Y, suggesting they represent early neoplasms (Hum Pathol 2002;33:761)
Differential Diagnosis