Introduction: The standard surgical procedure in urological practice that is performed in end stage/nonfunctioning kidney or in suspected malignant neoplasm is nephrectomy. It is indicated in patients who present with a wide range of clinical conditions that include obstruction, symptomatic chronic infections, calculus disease as well as severe traumatic injury to renal cell carcinomas. We conducted this study to assess the patterns of neoplastic and non-neeoplastic lesions in the nephrectomy specimen in a tertiary care hospital. Materials and Methods: This retrospective study was done over a period of twelve year where all nephrectomy cases were taken out from the records of the department and reviewed. Demographic details and the histopathological reports of the patients were recorded. Results: Total 111 cases were studied. There were 70 non-neoplastic lesions and 41 neoplastic lesions. Most common non-neoplastic lesion was chronic pyelonephritis. Majority of cases of chronic pyelonephritis belonged to
age group 21-30 years. Most common neoplastic lesion was RCC in adults. Most of the patients were in age group 41–50 years. Most common neoplastic lesion was wilm’s tumor in children. Rare renal pathologies were congenital mesoblastic nephroma in children and angiomyolipoma and squamous cell carcinoma in adult. Conclusion: A variety of non-neoplastic and neoplastic lesions present in the hospital which undergo nephrectomy. Many lesions can be clinically and radiologically misdiagnosed, so every nephrectomy specimen should be subjected to a detailed histopathological examination. In renal cell carcinoma, nuclear grade and staging of tumors are necessary for therapy and prognosis.

Keywords: Nephrectomy; Chronic pyelonephritis; Clear cell renal cell carcinoma; Congenital Mesoblastic nephroma; Angiomyolipoma and Squamous cell carcinoma.