Immunohistochemisery test on paraffin embedded tissue revealed positive reaction for P504 antibody. Figure 5: Nephrogenic adenoma. Immunohistochemisery test on paraffin embedded tissue revealed negative reaction for P63 antibody. Figure 6: Nephrogenic adenoma. Immunohistochemisery test on paraffin embedded tissue revealed negative reaction

for PSA antibody. Discussion Nephrogenic adenoma is a rare bladder lesion presented with well-defined mass located mostly beneath the epithelium. In the past, it was believed that nephrogenic adenoma represented metaplasia of the urinary epithelium in response to inflammatory process. However, it has been demonstrated to result from urothelial shedding, and implant in injured area. Adenocarcinoma Inhibitors,research,lifescience,medical of the bladder was reported to occur two year after nephrogenic adenoma in a 25-year-old man.8 Few reports have examined the use of immunohistochemical findings in the diagnosis of nephrogenic adenoma. Inhibitors,research,lifescience,medical Alsanjary et al. studied the morphological

and immunohistochemical features for differential diagnosis of nephrogenic adenoma from clear cell adenocarcinoma.9 Immunohistochemical study can differentiate nephrogenic adenoma from malignant process, and define the origin of adenoma. Immunohistochmistery studies have shown that PAX2 was positive only in remnant of fetal renal tubules and nephrogenic adenoma, Inhibitors,research,lifescience,medical and negative in malignant process such as prostatic adenocarcinoma.10 Cytoplasmic staining for CK7 and absence of staining for PSA is in favor of nephrogenic adenomaAlpha-methylacyl-CoA racemase (AMACR, P504S), which is the most useful marker for the diagnosis Inhibitors,research,lifescience,medical of prostatic adenocarcinoma,

is detected in nephrogenic adenoma of urinary bladder.10,11 There are some problems in the differential diagnosis of nephrogenic Inhibitors,research,lifescience,medical adenoma from clear cell carcinoma of bladder, because it shows foci with tubular, cystic and papillary configuration, but no dysplastic changes. Nephrogenic adenom can be differentiated from clear cell carcinoma by PAX2 marker.12 Reporting eight patients with nephrogenic adenoma, Chen et al. found high postoperative recurrence, and recommended careful long-term follow up.13 Olivia and Young reviewed 80 cases of nephrogenic adenoma, which showed a trend of male Tolmetin predominance.14 Koirala et al. reported a case of ureter nephrogenic adenoma with intraluminal PAS positive material.15 Jalpota reported an extensive involvement of bladder by nephrogenic adenoma in patient with renal allograft transplant.16 Nephrogenic adenoma is a benign metaplastic response to urothelial injury, and may mimic malignant process. In the present case bladder biopsy was done with high suspicion for malignant lesion. However, immunohisthochmical Abiraterone solubility dmso examination of the biopsy revealed positive findings for CK7, EMA, CD10 and AMACR, and negative findings for PSA, P63 and CK20. Such findings are in favor of nephrogenic adenoma as benign lesion.