Khan Iftikhar, Obeid Mahmoud, Hasan Nasreen, Jaradat Fayyad, Sengupta Bodhisatwa, Tabbal Mahmoud, Alsaif Abdullah, Tawfeeq Mansour, Al Qahtani Mohammad
Department of Transplant Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Department of Pathology, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Case Rep Transplant. 2020 Oct 16;2020:8831966. doi: 10.1155/2020/8831966. eCollection 2020.
Nephrogenic adenoma is a rare lesion that consists of epithelial cells arranged in tubular form, resembling tubules in the renal medulla, and is found usually in the urinary bladder although it can occur anywhere in the transitional epithelium of the lower urinary tract. The first case of nephrogenic adenoma of the urinary bladder was reported before the first kidney transplantation, and the lesion has been reported in patients with and without renal transplantation. The origin of cells in nephrogenic adenoma is debated and has been postulated to arise from cells of embryonic origin or from metaplasia secondary to chronic irritation or from implantation of allograft cells in patients with kidney transplantation. The long-term outcome and potential to convert into malignancy are not established, and therefore, there are no recommendations on how to follow up these patients. We present a case of a patient who was found to have nephrogenic adenoma of the urinary bladder during his second kidney transplantation from a cadaveric donor. He had undergone living donor kidney transplantation previously which subsequently failed. The patient did not manifest any symptoms of nephrogenic adenoma. During a follow-up period of 5 years, he has not manifested any symptoms related to nephrogenic metaplasia. Histopathological examination 5 years after the second transplantation did not show any malignant change. It can be concluded that nephrogenic adenoma is likely to behave in benign fashion post kidney transplantation.
肾源性腺瘤是一种罕见的病变，由呈管状排列的上皮细胞组成，类似于肾髓质中的小管，通常见于膀胱，尽管它可发生在下尿路移行上皮的任何部位。膀胱肾源性腺瘤的首例病例在首例肾移植之前就已报道，该病变在有或没有肾移植的患者中均有报道。肾源性腺瘤细胞的起源存在争议，据推测其起源于胚胎来源的细胞、继发于慢性刺激的化生或肾移植患者同种异体移植细胞的植入。其长期预后及恶变潜能尚未明确，因此，对于如何随访这些患者尚无相关建议。我们报告一例患者，在其接受来自尸体供体的第二次肾移植时发现患有膀胱肾源性腺瘤。他此前曾接受活体供肾移植，但随后移植失败。该患者未表现出肾源性腺瘤的任何症状。在5年的随访期内，他未出现任何与肾化生相关的症状。第二次移植5年后的组织病理学检查未显示任何恶性变化。可以得出结论，肾源性腺瘤在肾移植后可能表现为良性。
