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PAX2: a reliable marker for nephrogenic adenoma
Guo-Xia Tong1, Jonathan Melamed, Mahesh Mansukhani
1Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. gt2125@columbia.edu
Summary
PAX2, a renal transcription factor, is a specific marker for identifying nephrogenic adenoma. This finding aids in distinguishing it from other urinary tract cancers, improving diagnostic accuracy.
Area of Science:
- Uropathology
- Oncology
- Molecular Pathology
Background:
- Nephrogenic adenoma is a rare urinary tract lesion.
- Misdiagnosis, particularly with prostate adenocarcinoma, can occur.
- Current immunohistochemical markers offer limited diagnostic aid.
Purpose of the Study:
- Investigate PAX2 expression in nephrogenic adenoma.
- Determine PAX2's utility in differentiating nephrogenic adenoma from prostate adenocarcinoma and urothelial carcinoma.
- Explore the origin of non-transplant-related nephrogenic adenoma.
Main Methods:
- Examined PAX2 expression in 39 nephrogenic adenomas, 100 prostate adenocarcinomas, and 47 urothelial carcinomas.
- Utilized immunohistochemical staining for PAX2, CD10, and uroplakins.
- Correlated findings with clinical and histological data.
Main Results:
- Strong, distinct nuclear PAX2 staining was observed in 100% of nephrogenic adenomas.
- PAX2 was negative in normal prostate, normal urothelium, prostate adenocarcinoma, and urothelial carcinoma.
- CD10 showed focal expression in some nephrogenic adenomas and other tissues; uroplakins were negative in nephrogenic adenoma.
Conclusions:
- PAX2 is a highly specific and sensitive marker for diagnosing nephrogenic adenoma.
- Findings suggest nephrogenic adenoma may originate from renal epithelium, even in non-transplant patients.
- PAX2 aids significantly in the differential diagnosis of urinary tract lesions.