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December 29, 2017

Embryonal Hyperplasia of Bowman’s Capsule Epithelium

Embryonal Hyperplasia of Bowman's Capsule Epithelium

H&E and PAS-stained sections from the kidney of an 8-year-old male with advanced nephrosclerosis of unknown etiology. An exuberant proliferation of epithelial cells with an embryonal or immature appearance, arranged in a tubular and nodular pattern, is seen surrounding globally sclerotic glomeruli.  This unusual finding termed “embryonal hyperplasia/metaplasia of Bowman’s capsule epithelium” has been described in patients with end-stage renal disease on long-term dialysis. More recently, this finding has also been associated with WT1 mutations in patients with Denys-Drash syndrome and isolated diffuse mesangial sclerosis. The clinical significance of this finding is yet to be determined.

Embryonal Hyperplasia of Bowman's Capsule Epithelium


1. Hughson MD, McManus JFA, Hennigar GR. Studies on “end-stage” kidneys. II Embryonal hyperplasia of Bowman’s capsular epithelium. Am J Pathol. 1978; 91: 71-84.

2. Fukuzawa R, Eccles MR, Ikeda M, et al. Embryonal hyperplasia of Bowman’s capsular epithelium in patients with WT1 Pediatr nephrol. 2003; 18: 9-13