Papillary renal neoplasm with reverse polarity: an observational study of histology, immunophenotypes, and molecular variation

Huan Han ¹, Shu-Yi Yin ¹, Rui-Xiang Song ²

⁰Department of Pathology, Changhai Hospital, Naval Medical University, Shanghai, China.

Translational Andrology and Urology +

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April 9, 2024

View abstract on PubMed

Summary

Papillary renal neoplasm with reverse polarity (PRNRP) is a distinct renal tumor. GATA3 positivity and KRAS mutations aid diagnosis, with PRNRP showing an excellent prognosis after surgery.

Area Of Science

Nephrology
Oncology
Pathology

Background

Papillary renal neoplasm with reverse polarity (PRNRP) is a rare renal tumor entity.
Limited clinical data exists for PRNRP, necessitating further characterization.

Purpose Of The Study

To analyze clinical, histomorphological, immunohistochemical, and molecular features of PRNRP.
To differentiate PRNRP from other renal tumors with papillary structures.
To evaluate the prognosis of PRNRP patients.

Main Methods

Retrospective analysis of nine PRNRP cases.
Histomorphological and immunohistochemical evaluation.
Sanger sequencing for KRAS mutation analysis.

Main Results

PRNRP tumors were solitary, small, and well-circumscribed with predominant papillary formations.
Tumor cells showed reverse polarity with low-grade nuclei at the apical pole.
All PRNRP cases were GATA3-positive, and seven had KRAS mutations.
Patients experienced good prognosis and remained relapse-free post-surgery.

Conclusions

PRNRP is a distinct renal tumor subtype with specific pathological features and indolent behavior.
GATA3 positivity, KRAS mutation, and inverted nuclear pattern are key diagnostic markers.
PRNRP has a satisfactory prognosis, warranting tailored surveillance strategies.

Keywords:

GATA3 KRAS mutation Papillary renal cell carcinoma (PRCC) renal tumor