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Kidney tumor - cysts, children, adult benign

Cystic non-neoplastic lesions

Mesothelial cysts


Reviewers: Mandolin Ziadie, M.D. (see Reviewers page)
Revised: 30 December 2011, last major update December 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

General
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● Rare; cysts lined by mesothelial cells in vicinity of kidney that may present as renal masses
● Also called primary retroperitoneal cysts of mesothelial origin

Clinical features
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Radiologic images:

Figure 1A: MRI shows cystic mass (arrows) involving upper pole; fig 1B: cystic mass (arrows) at lower pole

Gross description
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● Thin-walled, unilocular cyst filled with clear fluid
● May be hemorrhagic

Gross images
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Fig A/B: hemorrhagic unilocular cysts

Micro description
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● Thin-walled cyst lined by single cell lining of non-pleomorphic cells with abundant eosinophilic cytoplasm, vesicular nuclei and small nucleoli
● May have small gland-like spaces

Micro images
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Cyst lining cells have abundant eosinophilic cytoplasm, vesicular nuclei and small nucleoli


Cyst lining cells are CEA-, keratin+, HBME1+ and WT1+

Positive stains
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● Alcian blue, keratin, vimentin, HBME1, WT1, thrombomodulin and calretinin

Negative stains
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● BerEP4, CEA, B72.3 and LeuM1

Differential diagnosis
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● Mucinous cystadenoma: ovarian-like stroma, mucin+, CEA+, negative for hyaluronic acid
● Lymphangioma: multicystic, has smooth muscle and lymphocytes in cyst wall and lumen, keratin+
● Simple hemorrhagic cyst

Additional references
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Arch Pathol Lab Med 2000;124:766

End of Kidney tumor - cysts, children, adult benign > Cystic non-neoplastic lesions > Mesothelial cysts


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