Kidney: Papillary adenoma

2008-10-01   Laurie J Eisengart , Ximing J Yang 

1.Department of Pathology, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
2.Department of Pathology, Brigham and Womens Hospital, Boston, MA.



Papillary adenomas are benign renal tumors that are, based on the 2016 WHO classification of renal tumors, low grade papillary neoplasms that are 15mm or fewer in diameter (Moch et al., 2016). This defining size for papillary adenoma was increased from 5mm in the prior WHO classification as metastases from these tumors are not observed in lesions that are ≤15mm.


Review on Renal papillary adenoma, with data on clinics, and the genes involved.

Clinics and Pathology


Papillary adenomas are common. They have been reported in 7% of nephrectomy specimens and 10-40% of autopsy kidneys. In autopsy series, the lesions are more common in older patients (10% of patients 70 years) and in patients with end stage kidney disease. Papillary adenomas may be found more frequently in resected kidneys with papillary renal cell carcinoma, and in patients with hereditary RCC, renal vascular disease, end-stage renal disease or acquired cystic kidney disease.


Most renal papillary adenomas are discovered incidentally at nephrectomy for another disease. However, with better imaging more tumors may be identified preoperatively. Multiple, bilateral papillary adenomas are referred to as renal adenomatosis.


The current World Health Organization (WHO) classification of kidney tumors defines renal papillary adenomas as unencapsulated epithelial tumors lesions with a tubulo-papillary architecture measuring ≤ 15mm and of low nuclear grade (Eble et al., 2016). The tumors morphologically resemble PRCC with papillary to tubulopapillary architecture and CK7 expression. By definition, cytologic aypia and necrosis are absent (Fig. 1).
Atlas Image
Figure 1: Histologically, papillary adenomas resemble low grade papillary RCC, but are < 15 mm in greatest dimension.


Although very little is typically done for small renal masses


It has been proposed that renal papillary adenomas are precursor lesions of papillary renal cell carcinoma. In addition to the epidemiologic association with PRCC (see above), papillary adenomas and PRCC show similar immunohistochemical expression of alpha-methylacyl-coenzyme A racemase ( AMACR ). Interestingly, papillary adenomas arising in the setting of acquired polycystic kidney disease do not show AMACR expression, suggesting a different biological mechanism for these neoplasms.


Excellent for this benign lesion. Renal papillary adenomas theoretically have no metastatic potential.



Trisomy 7 and 17, and loss of the Y chromosome are common changes in papillary adenomas.There are no definitive cytogenetic differences between the small tumors classified as adenomas and PRCC.

Highly cited references

Pubmed IDYearTitleCitations
357143812022Associations of systemic inflammatory markers with the risks of chronic heart failure: A case-control study.0
355519992022Tunable three-dimensional engineered prostate cancer tissues for in vitro recapitulation of heterogeneous in vivo prostate tumor stiffness.0
354355922022A Study on microRNAs Targeting the Genes Overexpressed in Lung Cancer and their Codon Usage Patterns.0
349338692022Average corticosteroid dose and risk for HBV reactivation and hepatitis flare in patients with resolved hepatitis B infection.0
353151642022Automatic market research of mobile health apps for the self-management of allergic rhinitis.0
352241262022Costs and Resource Use Among Patients with Cervical Cancer, Cervical Intraepithelial Neoplasia, and Genital Warts in Algeria.0
346278552022Curiosity helps: Growth in need for cognition bidirectionally predicts future reduction in anxiety and depression symptoms across 10 years.0
350148362022Graphene Microelectrodes for Real-Time Impedance Spectroscopy of Neural Cells.0
346569152021Prognostic significance of flat T-waves in the lateral leads in general population.0
348773792021QR-DN1.0: A new distorted and noisy QRs dataset.0
348101842021Health care utilisation following childhood acute lymphoblastic leukaemia: a population-based matched cohort study.1
347464642021Health-related food advertising on kid YouTuber vlogger channels.1
347210162021Cost-Effectiveness of Testing for NS5A Resistance to Optimize Treatment of Elbasvir/Grazoprevir for Chronic Hepatitis C in China.0
340897702021Associations of time-varying obesity and metabolic syndrome with risk of incident heart failure and its subtypes: Findings from the Multi-Ethnic Study of Atherosclerosis.0
347228102021Proton Therapy of Prostate and Pelvic Lymph Nodes for High Risk Prostate Cancer: Acute Toxicity.0
343573952021Evaluation of Hemoglobin Cutoff Levels to Define Anemia Among Healthy Individuals.0
339637562021Using Pressure Mapping to Optimize Hospital-Acquired Pressure Injury Prevention Strategies in the Burn Intensive Care Unit.0
343573122021Genome Sequence of the Asian Honeybee in Pakistan Sheds Light on Its Phylogenetic Relationship with Other Honeybees.0
343210242021Associations of environment and lifestyle factors with suboptimal health status: a population-based cross-sectional study in urban China.1
334613642021Satisfaction with life and SF-36 vitality predict risk of ischemic heart disease: a prospective cohort study.1
338806252021Investigating Acute and Subchronic Effects of Neonicotinoids on Northwestern Salamander Larvae.1
323891612021Diet quality, general health and anthropometric outcomes in a Latin American population: evidence from the Colombian National Nutritional Survey (ENSIN) 2010.0
337772342021Safety and efficacy of a feed additive consisting on Propionibacterium freudenreichii ssp. shermaniiATCC PTA-6752 for all animal species (Chr. Hansen A/S).3
337772332021Safety and efficacy of a feed additive consisting on Ligilactobacillus animalis ATCC PTA-6750 (formerly Lactobacillus animalis) for all animal species (Chr. Hansen A/S).0
335749372021Erratum: Ovarian cancer proliferation and apoptosis are regulated by human transfer RNA methyltransferase 9-like via LIN9.0
332478622021Hepatitis B infection and risk factors among pregnant women and their male partners in the Baby Shower Programme in Nigeria: a cross-sectional study.3
347078602021Enhancement of EPC migration by high-dose lisinopril is superior compared to captopril and ramipril.0
331009182020Got Glycogen?: Development and Multispecies Validation of the Novel Preserve, Precipitate, Lyse, Precipitate, Purify (PPLPP) Workflow for Environmental DNA Extraction from Longmire's Preserved Water Samples.2
329513242020Clozapine-associated severe eosinophilia following lithium rebound neutropenia: A case report.1
327072722020Legacy and emerging organophosphorus flame retardants and plasticizers in indoor microenvironments from Guangzhou, South China.0
330336502020Rapid high-fidelity contour shaping of titanium mesh implants for cranioplasty defects using patient-specific molds created with low-cost 3D printing: A case series.1
355181602020Inhibition of SARS-CoV-2 main protease by phenolic compounds from Manilkara hexandra (Roxb.) Dubard assisted by metabolite profiling and in silico virtual screening.4
332737622020Pial arteriovenous fistula: A clinical and neuro-interventional experience of outcomes in a rare entity.0
326999462020A 3i hip fracture liaison service with nurse and physician co-management is cost-effective when implemented as a standard clinical program.1
324929342020Improving Multi-Tumor Biomarker Health Check-up Tests with Machine Learning Algorithms.4
325374502020Designing Uniformly Layered FeTiO3 Assemblies Consisting of Fine Nanoparticles Enabling High-Performance Quasi-Solid-State Sodium-Ion Capacitors.1
329875472020Modelling the effects of media coverage and quarantine on the COVID-19 infections in the UK.7
324230462020Basidiospores from Wood-Decay Fungi Transform Laccase Substrates in the Absence of Glucose and Nitrogen Supplements.1
324053972020Optimizing water and phosphorus management to improve hay yield and water- and phosphorus-use efficiency in alfalfa under drip irrigation.2
319082662020Prevalence and morphological and molecular characteristics of Sarcocystis bertrami in horses in China.1
317573552020Erratum to "Spontaneous Closure Rates of Ventricular Septal Defects (6,750 Consecutive Neonates)".0
316732252019Associations of rs524952 and rs634990 gene polymorphisms in 15q14 with high myopia: A meta-analysis.1
311656562019A Comparative Analysis of the Risk Profiles of Australian Young Offenders From Rural and Urban Communities.0
315132862019Perinatal risk factors associated with skin infection hospitalisation in Western Australian Aboriginal and Non-Aboriginal children.1
312087002019Spontaneous Closure Rates of Ventricular Septal Defects (6,750 Consecutive Neonates).5
295957552019The Pseudo-Pelger huët Cell as a Retrospective Dosimeter: Analysis of a Radium Dial Painter Cohort.0
310124002019Accuracy of cardiac auscultation in detection of neonatal congenital heart disease by general paediatricians.1
309309412019Genomic, Transcriptomic, and Epigenomic Features Differentiate Genes That Are Relevant for Muscular Polyunsaturated Fatty Acids in the Common Carp.3
309179902019Comparative efficacy and acceptability of non-surgical brain stimulation for the acute treatment of major depressive episodes in adults: systematic review and network meta-analysis.45
306733402019Pilot Study to Diagnose Nonalcoholic Steatohepatitis With Dynamic 18F-FDG PET.6
303618502019Chronic kidney disease and kidney health care status: the healthy life in Suriname (HeliSur) study.1
317962612019Contribution of genetic, biochemical and environmental factors on insulin resistance and obesity in Mexican young adults.2
306744652019Impact and sustainability of centralising acute stroke services in English metropolitan areas: retrospective analysis of hospital episode statistics and stroke national audit data.26
317885042019IMPT versus VMAT for Pelvic Nodal Irradiation in Prostate Cancer: A Dosimetric Comparison.4
302670462019Myocilin Gene Gln368Ter Variant Penetrance and Association With Glaucoma in Population-Based and Registry-Based Studies.9
305449232018Validation of the REGARDS Severe Sepsis Risk Score.2
302553192018Healthcare-related costs in very elderly intensive care patients.3
298823732018Eccrine Sweat as a Biofluid for Profiling Immune Biomarkers.13
288671752018Thrombo-hemorrhagic liability in children with congenital heart diseases.1
296634902018Body size-dependent bioaccumulation, tissue distribution, and trophic and maternal transfer of phenolic endocrine-disrupting contaminants in a freshwater ecosystem.2
299438022018Influenza vaccine for chronic obstructive pulmonary disease (COPD).30
299258782018Spatial maps of prostate cancer transcriptomes reveal an unexplored landscape of heterogeneity.124
297354722018Scaling PatientsLikeMe via a "Generalized Platform" for Members with Chronic Illness: Web-Based Survey Study of Benefits Arising.13
294496542018Analysis combining correlated glaucoma traits identifies five new risk loci for open-angle glaucoma.15
306263032018Australian Group on Antimicrobial Resistance (AGAR) Australian Gram-negative Sepsis Outcome Programme (GNSOP) Annual Report 2016.0
294974422018Clinical evaluation of Class II and Class III gingival recession defects of maxillary posterior teeth treated with pedicled buccal fat pad: A pilot study.0
293720362018Histomorphometric evaluation of mice testicular tissue following short- and long-term effects of lipopolysaccharide-induced endotoxemia.0
289884662017Characterization of ancient lipids in prehistoric organic residues: Chemical evidence of livestock-pens in rock-shelters since early neolithic to bronze age.0
293831282017Genome-wide identification of long non-coding RNA and mRNA profiling using RNA sequencing in subjects with sensitive skin.9
291197382017Physiological characterization, transcriptomic profiling, and microsatellite marker mining of Lycium ruthenicum.5
288745952017A Randomized Controlled Trial of an Additional Funding Intervention to Improve Clinical Trial Enrollment.1
282888372017Can Cranberries Contribute to Reduce the Incidence of Urinary Tract Infections? A Systematic Review with Meta-Analysis and Trial Sequential Analysis of Clinical Trials.20
287726742017Microwave-Assisted Catalytic Synthesis of Bio-Based Copolymers from Waste Cooking Oil.0
279559452017Smartphone text message service to foster hand hygiene compliance in health care workers.2
282613432017Pretreatment Alkaline Phosphatase and Epstein-Barr Virus DNA Predict Poor Prognosis and Response to Salvage Radiotherapy in Patients with Nasopharyngeal Carcinoma and Metachronous Bone-Only Metastasis.7
266958192017High inspired oxygen versus low inspired oxygen for reducing surgical site infection: a meta-analysis.3
274856642017A meta-analysis of reflux genome-wide association studies in 6750 Northern Europeans from the general population.9
277147192017Platelet distribution width predicts left ventricular dysfunction in patients with acute coronary syndromes treated with percutaneous coronary intervention.2
285804032016Damage accumulation of bovine bone under variable amplitude loads.2
271809872016Population pharmacokinetic modeling and simulation of huperzine A in elderly Chinese subjects.4
270871122016Pittosporum cryptic virus 1: genome sequence completion using next-generation sequencing.1
275826832016Hematologic parameters as the predictors for metabolic syndrome in perimenopausal and postmenopausal women living in urban area: a preliminary report.3
269690162016The proteome and phosphoproteome of maize pollen uncovers fertility candidate proteins.9
270551172016Cost Attributable to Nosocomial Bacteremia. Analysis According to Microorganism and Antimicrobial Sensitivity in a University Hospital in Barcelona.14
281223702016Comparison of Dolphins' Body and Brain Measurements with Four Other Groups of Cetaceans Reveals Great Diversity.9
271120052015[Response of water coupling with N supply on maize nitrogen uptake, water and N use effi- ciency, and yield in drip irrigation condition].0
260985612015Evidence of a Double Burden of Malnutrition in Urban Poor Settings in Nairobi, Kenya.62
256278022015Active case surveillance, passive case surveillance and asymptomatic malaria parasite screening illustrate different age distribution, spatial clustering and seasonality in western Kenya.26
251385602015Cancer risks and long-term community-level exposure to pentachlorophenol in contaminated areas, China.1
251495572014Biometry and corneal astigmatism in cataract surgery candidates from Southern China.15
248071702014The 3rd International Standard for serum IgE: international collaborative study to evaluate a candidate preparation.6
249769652014Online eLearning for undergraduates in health professions: A systematic review of the impact on knowledge, skills, attitudes and satisfaction.121
243710612014Evaluation of three live attenuated H2 pandemic influenza vaccine candidates in mice and ferrets.11
249768792013Genome sequence of the clover-nodulating Rhizobium leguminosarum bv. trifolii strain SRDI565.2
244171102013[Effects of water and nitrogen regulation on the yield and water and nitrogen use efficiency of cotton in south Xinjiang, Northwest China under plastic mulched drip irrigation].0
239694602013An observational correlation between stellar brightness variations and surface gravity.2
238477452013On-chip laser Doppler vibrometer for arterial pulse wave velocity measurement.8
240006202013[Development of coloproctology in the Vishnevsky Central Military Clinical Hospital N 3].0
235002752013Impact of repeat myocardial revascularization on outcome in patients with silent ischemia after previous revascularization.7


Pubmed IDLast YearTitleAuthors
120706002002Numerical chromosomal aberrations in papillary renal cortical tumors: relationship with histopathologic features.Henke RP et al
152043762004Chromosomal gains and losses detected by comparative genomic hybridization and proliferation activity in renal cell carcinoma.Kallio JP et al
19585901991Cytogenetics of papillary renal cell tumors.Kovacs G et al
124076972002Renal cancer: cytogenetic and molecular genetic aspects.Meloni-Ehrig AM et al
85487681996Genetic aberrations detected by comparative genomic hybridization are associated with clinical outcome in renal cell carcinoma.Moch H et al
123774132002Analysis of kidney tumors by comparative genomic hybridization and conventional cytogenetics.Rigola MA et al
187966652008Management of the incidental renal mass.Silverman SG et al
170560942007Renal papillary adenoma--a putative precursor of papillary renal cell carcinoma.Wang KL et al

External Links


Laurie J Eisengart ; Ximing J Yang

Kidney: Papillary adenoma

Atlas Genet Cytogenet Oncol Haematol. 2008-10-01

Online version:

Historical Card

0000-00-00 Kidney: Papillary adenoma by  Kelsey McIntyre,Michelle S. Hirsch 

Department of Pathology, Brigham and Womens Hospital, Boston, MA.