Kidney tumor
Benign adult tumors
Papillary adenoma

Topic Completed: 1 March 2012

Revised: 21 August 2019

Copyright: 2003-2019,, Inc.

PubMed Search: "Papillary adenoma" kidney

Mandolin S. Ziadie, M.D.
Page views in 2018: 6,833
Page views in 2019 to date: 5,182
Cite this page: Ziadie MS. Papillary adenoma. website. Accessed August 21st, 2019.
Definition / general
  • Low grade (usually) neoplasm also known as renal cortical adenoma
  • Commonly found at autopsy: 10% at age 21 - 40 years, 40% at age 70 - 90
  • Increasing numbers during life are being detected with more widespread whole body imaging
Clinical features
  • Associated with chronic pyelonephritis, renal vascular disease, von Hippel-Lindau syndrome, long term hemodialysis and acquired cystic disease (in 1/3)
  • Multiple adenomas associated with papillary renal cell carcinoma (Hum Pathol 2007;38:239)
Classification (WHO 2016)
  • Papillary adenoma: 1.5 cm or less
  • Renal cell carcinoma, papillary type: > 1.5 cm
Case reports
Gross description
  • Well circumscribed, unencapsulated pale tumor in subcapsular kidney
  • Usually 0.5 cm or smaller
Gross images

AFIP images

1.5 cm subcapsular tumor

Microscopic (histologic) description
  • Dense papillary / tubular / tubulopapillary architecture composed of small cuboidal cells with scant amphophilic to basophilic cytoplasm, round / oval nuclei (minimal anaplasia - Fuhrman grade 1 / 2) with stippled to clumped chromatin and indistinct nucleoli
  • Variable nuclear grooves, no / rare mitotic figures
  • Psammoma bodies / xanthoma cells may be present
  • Classified as type 1 (basophilic) or type 2 (eosinophilic), based on criteria for papillary renal cell carcinoma
  • Note: small tumors of clear cells are considered to be small renal cell carcinomas, clear cell type and with malignant potential
Microscopic (histologic) images

Case of the Week #43

Incidental tumor

AFIP images

Xanthoma cells in stroma; type 1 (basophilic) tumors

Tubular structures lined by cuboidal cells with small nuclei

Circumscribed but nonencapsulated tumor

Tiny tumor has papillary architecture

Images hosted on other servers:

Xanthoma cells in stroma; type 1 (basophilic) tumors

Molecular / cytogenetics description
  • Gains of #7, 17, 16, 12 and 20 and loss of Y occur early in papillary renal cell neoplasia (Mod Pathol 2003;16:1053)
Molecular / cytogenetics images

Images hosted on other servers:

Fig A: single Y present in normal tubules;
Fig B: gain of #12 (3 signals) in papillary adenoma

Additional references
Back to top