Estrogen and progesterone-receptor-positive stroma as a non-tumorous proliferation in kidneys: A possible metaplastic response to obstruction Journal Article


Authors: Tickoo, S. K.; Gopalan, A.; Tu, J. J.; Harik, L. R.; Al-Ahmadie, H. A.; Fine, S. W.; Olgac, S.; Reuter, V. E.
Article Title: Estrogen and progesterone-receptor-positive stroma as a non-tumorous proliferation in kidneys: A possible metaplastic response to obstruction
Abstract: The presence of estrogen and progesterone-receptor-positive stroma is well known in renal mixed epithelial and stromal tumor, cystic nephroma, and angiomyolipoma with epithelial cysts. It has been suggested that the hormone receptor positivity in mixed epithelial and stromal tumor may be etiologically related to exogenous hormone intake - a phenomenon that has become more frequent in recent years. In the past few years, we have observed such stroma in some non-neoplastic kidneys, as well as in tumor-bearing kidneys away from the tumor. Herein we present our experience with 10 such cases. In a prospective manner, whenever we noted stroma resembling that in ovaries or müllerian organs (endometrial or cervical-like) in kidneys removed for any cause, immunohistochemical stains for estrogen and progesterone receptors were performed. There were eight males and two females among the group, with ages ranging from 11 months to 71 years. In six cases, the nephrectomies were performed for a non-functional kidney, and in three for tumors (one each of chromophobe, clear cell, and acquired cystic disease-associated renal cell carcinoma). One case was a partial nephrectomy for vesico-ureteric reflux, with upper pole hydronephrosis. Such stroma was present in nine cases as a non-mass forming proliferation around dilated, frequently inflamed pelvicalyceal system and collecting ducts. In one it was present at the periphery of an acquired cystic disease-associated renal cell carcinoma, as well as around non-tumorous cysts. The only common finding in all cases was a generalized or segmental hydronephrosis, or tumor compression-related focal obstruction. The stroma was positive for estrogen receptors in all 10 cases, and for progesterone receptors in seven. Thus, estrogen- and progesterone receptor-positive stroma can be present in the kidney, not only as a component of certain tumors, but also in association with non-neoplastic conditions. Its association with obstructive changes suggests that it may represent a metaplastic change in the renal interstitial cells surrounding these obstructed epithelial structures. © 2008 USCAP, Inc All rights reserved.
Keywords: immunohistochemistry; clinical article; controlled study; human tissue; metaplasia; prospective study; prospective studies; cell proliferation; kidney carcinoma; kidney neoplasms; nephrectomy; ovary; kidney; partial nephrectomy; kidney tumor; infant; stroma; receptors, estrogen; receptors, progesterone; clear cell carcinoma; estrogen receptor; progesterone receptor; stromal cells; uterine cervix; muellerian duct; hydronephrosis; kidney collecting tubule; vesicoureteral reflux; obstruction; estrogen- and progesterone receptor-positive stroma; non-neoplastic kidney; ovarian and müllerian
Journal Title: Modern Pathology
Volume: 21
Issue: 1
ISSN: 0893-3952
Publisher: Nature Research  
Date Published: 2008-01-01
Start Page: 60
End Page: 65
Language: English
DOI: 10.1038/modpathol.3800958
PUBMED: 17873894
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 5" - "Export Date: 17 November 2011" - "CODEN: MODPE" - "Source: Scopus"
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MSK Authors
  1. Lara Rabih Harik
    8 Harik
  2. Semra Olgac
    98 Olgac
  3. Satish K Tickoo
    485 Tickoo
  4. Anuradha Gopalan
    417 Gopalan
  5. Samson W Fine
    462 Fine
  6. Victor Reuter
    1228 Reuter