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Pathology for Urologists

Juxtaglomerular Cell Tumor


Image A
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Image B
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  • 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.

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