Histological pattern of nephrectomy specimens: A fifteen-year review

Background: Nephrectomy is the surgical removal of all or part of a diseased kidney in a living person. Pathological assessment of the tissue specimen is required in most cases for eventual diagnosis and disease prognostication.

Objective: To demonstrate the pathological patterns of nephrectomy specimens in Nnewi, South East Nigeria.

Methods: The data of all the nephrectomy specimens submitted to the Department of Histopathology of the Nnamdi Azikiwe University Teaching Hospital, Nnewi, as well as Triple Green Diagnostic Clinics Ltd, Nnewi, from 2007 to 2021 were retrospectively reviewed. Their pathological features were analyzed.

Results: Of the 153 nephrectomy specimens, 141 that had complete data were used for the study. Those that had neoplastic lesions were 84(59.6%), while 57(40.4%) were non-neoplastic. Of the neoplastic lesions, 79 (94%) were malignant and renal cell carcinoma (RCC) accounted for 60%, with a mean age of 48.8±18.1 years and median age 52.5 years. RCC occurred commonly in the sixth decade of life (26%) with male preponderance (56%) and predominantly involving the left kidney (64%). Clear cell variant of renal cell carcinoma was the most common (52%), followed by papillary variant (34%). Nephroblastoma was the most common malignancy in the first decade with a modal age of 2years. Chronic pyelonephritis was the most common non-neoplastic lesions.

Conclusion: Nephrectomy is done for a wide range of renal pathology, with more done for neoplastic conditions than non-neoplastic ones.