Juxtaglomerular cell tumor: Difference between revisions
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==Pathology== |
==Pathology== |
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By hypersecretion of renin, JCT causes hypertension, often severe and usually sustained but occasionally paroxysmal, <ref>{{cite journal|last=W. Hanna et al|title=Juxtaglomerular cell tumour (reninoma) with paroxysmal hypertension|journal=Can Med Assoc J.|date=1979 April 2|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1819229/pdf/canmedaj01444-0065.pdf}}</ref> and [[secondary hyperaldosteronism]] inducing [[hypokalemia]], though the later can be mild despite high renin.<ref>{{cite journal|journal=Nature Clinical Practice Nephrology|last=Beaudoin|first=J.|coauthors=Périgny M, Têtu B, Lebel M.|title=A Patient With A Juxtaglomerular Cell Tumor With Histological Vascular Invasion|year=2008|url=http://www.nature.com/nrneph/journal/v4/n8/full/ncpneph0890.html|location=Laval University, Quebec City, QC, Canada. |pmid=18654602|doi=10.1038/ncpneph0890}}</ref> Both of these conditions may be corrected by surgical removal of the tumor.<ref name="pmid18192852">{{cite journal |
By hypersecretion of renin, JCT causes hypertension, often severe and usually sustained but occasionally paroxysmal, <ref>{{cite journal|last=W. Hanna et al|title=Juxtaglomerular cell tumour (reninoma) with paroxysmal hypertension|journal=Can Med Assoc J.|date=1979 April 2|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1819229/pdf/canmedaj01444-0065.pdf|pmc=1819229|pmid=436071|volume=120|issue=8|pages=957–9}}</ref> and [[secondary hyperaldosteronism]] inducing [[hypokalemia]], though the later can be mild despite high renin.<ref>{{cite journal|journal=Nature Clinical Practice Nephrology|last=Beaudoin|first=J.|coauthors=Périgny M, Têtu B, Lebel M.|title=A Patient With A Juxtaglomerular Cell Tumor With Histological Vascular Invasion|year=2008|url=http://www.nature.com/nrneph/journal/v4/n8/full/ncpneph0890.html|location=Laval University, Quebec City, QC, Canada. |pmid=18654602|doi=10.1038/ncpneph0890|volume=4|issue=8}}</ref> Both of these conditions may be corrected by surgical removal of the tumor.<ref name="pmid18192852">{{cite journal |
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| author = Wong L, Hsu TH, Perlroth MG, Hofmann LV, Haynes CM, Katznelson L |
| author = Wong L, Hsu TH, Perlroth MG, Hofmann LV, Haynes CM, Katznelson L |
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| title = Reninoma: case report and literature review |
| title = Reninoma: case report and literature review |
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| doi = 10.1097/HJH.0b013e3282f283f3 |
| doi = 10.1097/HJH.0b013e3282f283f3 |
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| url = http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?an=00004872-200802000-00030 |
| url = http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?an=00004872-200802000-00030 |
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}}</ref> Asymptomatic cases have been reported.<ref name="kuroda">{{cite journal|last=Naoto Kuroda et al|title=Review of juxtaglomerular cell tumor with focus on pathobiological aspect|journal=Diagnostic Pathology|year=2011| |
}}</ref> Asymptomatic cases have been reported.<ref name="kuroda">{{cite journal|last=Naoto Kuroda et al|title=Review of juxtaglomerular cell tumor with focus on pathobiological aspect|journal=Diagnostic Pathology|year=2011|pmc=3173291|pmid=21871063|doi=10.1186/1746-1596-6-80|volume=6|pages=80}}</ref> |
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==Diagnosis== |
==Diagnosis== |
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Revision as of 14:59, 1 December 2012
Juxtaglomerular cell tumor (JCT, JGCT, also reninoma) is an extremely rare kidney tumour of the juxtaglomerular cells that typically secretes renin. It often causes severe hypertension that is difficult to control, in adults and children, although among causes of secondary hypertension it is rare. It develops most commonly in young adults, but can be diagnosed much later in life. It is generally considered benign, but its malignant potential is uncertain.[1]
History
Juxtaglomerular cell tumor was first described in 1967 in a paper by Robertson et al, and first named by Kihara et al in 1968. Since then, approximately 100 case reports have been published.[2] Karyotyping of a small number of these tumors revealed a common loss of chromosomes 9 and 11.[1]
Pathology
By hypersecretion of renin, JCT causes hypertension, often severe and usually sustained but occasionally paroxysmal, [3] and secondary hyperaldosteronism inducing hypokalemia, though the later can be mild despite high renin.[4] Both of these conditions may be corrected by surgical removal of the tumor.[5] Asymptomatic cases have been reported.[2]
Diagnosis
Pre-operatively, hypertension, especially when severe or poorly controlled, combined with evidence of a kidney tumor via imaging or gross examination suggest a JCT. However, other kidney tumors can cause hypertension by secreting renin. JCTs have a variable appearance and have often being misdiagnosed as renal cell carcinomas; dynamic computed tomography is helpful in the differential diagnosis.[6] Post-operatively, presence of renin granules in pathology specimens differentiates this tumor from renal hemangiopericytoma and other renal tumors.[7]
Prognosis
JCT often is described as benign, however one case of metastasis has been reported, so its malignant potential is uncertain.[1] In most cases the tumor is encapsulated.[8]
References
- ^ a b c Capovilla M, Couturier J, Molinié V, Amsellem-Ouazana D, Priollet P, Baumert H, Bruneval P, Vieillefond A (2008). "Loss of chromosomes 9 and 11 may be recurrent chromosome imbalances in juxtaglomerular cell tumors". Hum. Pathol. 39 (3): 459–62. doi:10.1016/j.humpath.2007.08.010. PMID 18261631.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - ^ a b Naoto Kuroda; et al. (2011). "Review of juxtaglomerular cell tumor with focus on pathobiological aspect". Diagnostic Pathology. 6: 80. doi:10.1186/1746-1596-6-80. PMC 3173291. PMID 21871063.
{{cite journal}}: Explicit use of et al. in:|last=(help)CS1 maint: unflagged free DOI (link) - ^ W. Hanna; et al. (1979 April 2). "Juxtaglomerular cell tumour (reninoma) with paroxysmal hypertension" (PDF). Can Med Assoc J. 120 (8): 957–9. PMC 1819229. PMID 436071.
{{cite journal}}: Check date values in:|date=(help); Explicit use of et al. in:|last=(help) - ^ Beaudoin, J. (2008). "A Patient With A Juxtaglomerular Cell Tumor With Histological Vascular Invasion". Nature Clinical Practice Nephrology. 4 (8). Laval University, Quebec City, QC, Canada. doi:10.1038/ncpneph0890. PMID 18654602.
{{cite journal}}: Unknown parameter|coauthors=ignored (|author=suggested) (help) - ^ Wong L, Hsu TH, Perlroth MG, Hofmann LV, Haynes CM, Katznelson L (2008). "Reninoma: case report and literature review". J. Hypertens. 26 (2): 368–73. doi:10.1097/HJH.0b013e3282f283f3. PMID 18192852.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - ^ Tanabe; et al. (July 2001). "Dynamic computer tomography is useful in the differential diagnosis of juxtaglomerular cell tumor and renal cell carcinoma.Tanab". Hypertens Res.
{{cite journal}}: Explicit use of et al. in:|last=(help) - ^ Martin SA, Mynderse LA, Lager DJ, Cheville JC; Martin; Lager; Cheville (2001). "Juxtaglomerular cell tumor: a clinicopathologic study of four cases and review of the literature". Am. J. Clin. Pathol. 116 (6): 854–63. doi:10.1309/B10J-FKQ5-J7P8-WKU4. PMID 11764074.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - ^ Abbi RK, McVicar M, Teichberg S, Fish L, Kahn E (1993). "Pathologic characterization of a renin-secreting juxtaglomerular cell tumor in a child and review of the pediatric literature". Pediatr Pathol. 13 (4): 443–51. doi:10.3109/15513819309048234. PMID 8372029.
{{cite journal}}: CS1 maint: multiple names: authors list (link)
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