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REVIEW OF PEDIATRIC RENAL NEOPLASMS
John Hicks
Texas Children's Hospital, Houston, TX

CONGENITAL MESOBLASTIC NEPHROMA

INDEX

 

Congenital Mesoblastic Nephroma: Epidemiology
Most Common Renal Tumor of Early Infancy

62% Occur in First 3 months of Life

90% in First Year of Life

Mean Age = 2 months Gender Ratio 1.0M:1.0F

Asymptomatic Renal Mass

Some Detected During Prenatal Ultrasound

Polyhydramnios During Fetal Life -> Premature
Delivery

Hyper-reninism: Entrapped Normal Glomeruli With
Overproduction of Renin

Hypercalcemia: Prostaglandin E by Tumor Cells

 
 

Congenital Mesoblastic Nephroma: Pathology
Arise Unicentrally within Deep Parenchyma Near Renal Sinus

Most Unilateral Tumors

Infiltration of Renal Parenchyma with Indistinct Tumor-Kidney
Interface --- Requires Wide Resection

Whorled Appearance Like Leiomyoma

Hemorrhage, Necrosis and Cysts Unusual
Possibly Markers for Adverse Outcome

Most Behave in Benign Fashion

Cellular Variant: High Cell Density & Increased Mitoses

Composed of Spindle Cells (resembles infantile fibromatosis)
Entrapped Renal Tubules and Glomeruli
Cartilage
Hematopoietic Cells
Lymphocytes at Periphery
Tortuous Large Vascular Spaces

 

 

Congenital Mesoblastic Nephroma:  
Light microscopy (A) and Ultrastructure (B)
Mesoblastic nephroma - lm Mesoblastic nephroma - em
Figure 2A: Inerface between normal kidney and spindle cells of a mesoblastic nephroma. Renal tubules frequently become entrapped within this spindle cell tumor. Figure 2B: Plump spindled to ovoid cells with features of myofibroblasts separated by loose matrix material compose the tumorous cells. 

 
 


INDEX
Nephroblastoma (Wilms tumor)
Clear Cell Sarcoma
Malignant Rhabdoid Tumor
Renal Cell Carcinoma
Angiomyolipoma
Ossifying Tumor of Infantile Kidney

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