Histomorphological Spectrum of Lesions in Nephrectomy Specimens- A 5-Year Retrospective Study at a Tertiary Care Centre

Background: Nephrectomy specimens encompass a broad range of non-neoplastic and neoplastic renal lesions. Histopathological examination remains essential for establishing the exact diagnosis, identifying unexpected pathology, and guiding further patient management. The present study was undertaken to evaluate the histomorphological spectrum of lesions encountered in nephrectomy specimens over a 5-year period at a tertiary care centre. Material and Methods: This retrospective observational study included all nephrectomy specimens received in the Department of Pathology, NCR Medical College, from 1 January 2021 to 31 December 2025. Clinical details, indication for surgery, and type of nephrectomy were recorded. Archived hematoxylin and eosin-stained slides were reviewed, and special stains were assessed wherever required. The lesions were analyzed with respect to histopathological diagnosis, age, sex, and type of surgery performed. Results: A total of 60 nephrectomy specimens were studied. Non-neoplastic lesions constituted the majority of cases (52/60; 86.6%), whereas neoplastic lesions accounted for 8 cases (13.3%). Chronic pyelonephritis was the predominant lesion overall (41 cases; 68.3%) and represented the most frequent non-neoplastic indication for nephrectomy. Among neoplastic lesions, renal cell carcinoma was the most common tumor (5 cases; 8.3%). Other lesions identified included xanthogranulomatous pyelonephritis, renal tuberculosis, pyonephrosis, traumatic kidney, polycystic kidney disease, papillary urothelial carcinoma, primary renal lymphoma, and multilocular cystic renal neoplasm of low malignant potential. The most commonly affected age group was 41–50 years, and males were more frequently affected than females, with a male-to-female ratio of 1.5:1. Most specimens were total nephrectomies, while radical nephrectomy was performed in two malignant cases. Conclusion: Non-neoplastic renal lesions were more frequent than neoplastic lesions in nephrectomy specimens in the present study, with chronic pyelonephritis being the leading cause. Careful histopathological evaluation of every nephrectomy specimen is indispensable not only for definitive diagnosis but also for detecting incidental lesions, classifying malignancies, and contributing to appropriate patient management.

Keywords: Nephrectomy, chronic pyelonephritis, renal cell carcinoma, renal lesions, histopathology, tertiary care centre.