American Urological Association - Juxtaglomerular Cell Tumor
Juxtaglomerular Cell Tumor
- Rare source of hypertension, these tumors arise from the juxtaglomerular apparatus.
- Most patients are young adults (teens and 20's).
- Male > female.
- All patients have had hypertension with increased serum renin (hypertension does not respond to antihypertensive therapy).
- Elevated aldosterone and hypokalemia may also be present.
- Gross: Single, small yellow to gray-white nodules in the cortex.
- Histology: Quite variable:
- Typically composed of bland-looking round or polygonal cells with eosinophilic cytoplasm (image A).
- Numerous capillaries or branching blood vessels. (Solid growth around vessels of JCT cells resembles glomus tumor or "glomoid growth")
- Cells form irregular cords with a loose connective tissue stroma.
- Electron microscopy: secretory granules containing renin (rhomboid shaped crystals) (image B).
- Immunohistochemistry: diffuse renin+, CD34+.
- Typically behave in a benign fashion (rare metastasis).
- Surgical excision generally curative - not only of the tumor, but of the hypertension.