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Related Experiment Videos

Papillary renal neoplasm with reverse polarity shows benign behavior: Results from a 77-case clinicopathological and

Yong Il Lee1, Ja-Min Park1, Sun Young Yoon1

  • 1Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.

Annals of Diagnostic Pathology
|May 16, 2025
PubMed
Summary

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Papillary renal neoplasm with reverse polarity (PRNRP) is a low-grade renal tumor. Comprehensive analysis confirmed its benign nature, with no recurrence or death observed in patients.

Area of Science:

  • Uropathology
  • Renal Neoplasms
  • Oncology

Background:

  • Papillary renal neoplasm with reverse polarity (PRNRP) is a distinct low-grade renal tumor.
  • PRNRP is characterized by oncocytic cells, apical nuclei, GATA3 expression, and KRAS mutations.

Purpose of the Study:

  • To comprehensively characterize PRNRP through clinical, histological, immunohistochemical, and genetic analyses.
  • To determine the prognostic significance of PRNRP.
  • To review prior reports on PRNRP.

Main Methods:

  • Analysis of 506 patients with papillary renal cell carcinoma (PRCC) undergoing nephrectomy.
  • Reclassification of 77 cases (17%) as PRNRP.
  • Histological, immunohistochemical (GATA3, TFEB), and KRAS mutation analyses were performed.
Keywords:
KRASPapillary renal neoplasm with reverse polarityTranscription factor EB

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Main Results:

  • PRNRP cases were consistently pT1 tumors (median size 1.5 cm).
  • GATA3 expression was found in 97% of cases, TFEB in 86%.
  • KRAS exon 2 mutations were identified in all PRNRP cases, including atypical variants. No recurrence or death occurred during median follow-up (46 months).

Conclusions:

  • PRNRP is a low-grade renal tumor with a benign clinical course.
  • Diagnostic evaluation should include histological features, GATA3, and KRAS mutation analysis, especially for atypical cases.
  • This study reaffirms the favorable prognosis of PRNRP.