scholarly journals Multidetector Computed Tomography in the Evaluation of Renal Masses - A Prospective Study from Ambala, India

2021 ◽  
Vol 10 (21) ◽  
pp. 1583-1587
Author(s):  
Akshat Kuchhal ◽  
Sanjay Sethi ◽  
Ranjana Gupta ◽  
Kamal Sharma ◽  
Puneet Mittal ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Renal Cell Carcinoma ◽  
Prospective Study ◽  
Cell Carcinoma ◽  
Multidetector Computed Tomography ◽  
Renal Cell ◽  
Renal Mass ◽  
Renal Cyst ◽  
Renal Masses ◽  
A Prospective Study

BACKGROUND The advent of Multidetector Computed Tomography (MDCT) has created several important advances in the detection and characterization of renal masses due to its high accuracy, low cost, and easy availability. There is a growing need to separate benign lesions from malignant ones so as to provide an appropriate timely treatment. It can be used with contrast agents and helps in providing data during multiple phases along with the possibility of multiplanar image reconstruction anytime in the future. We wanted to study the role of CT imaging as a diagnostic modality for the evaluation of renal masses. METHODS This is a prospective study conducted among 50 cases, with clinically or radiologically diagnosed renal mass who were referred to our department . A detailed clinical history, thorough clinical examination, ultrasonography and multiphase - CECT using a Philips 128 - slice multi detector scanner (Ingenuity), were performed using the set - protocol followed by multiplanar reconstruction and detailed evaluation. Findings of CT scan were correlated with clinical / biopsy / surgical findings. RESULTS Renal cell carcinoma (RCC) was the most common renal mass in our study group (48 %) followed by renal cyst (30 %). The most common presenting symptom of RCC was haematuria (91.6 %) followed by flank pain (58.3 %). Renal cyst was a fairly common lesion with majority (93.3 %) being BOSNIAK - I category. RCC most commonly showed malignant extension via lymph nodes (83.3 %) while transitional cell cancer (TCC) most commonly spread via ureteric extension (75 %). Inferior vena cava (IVC) extension, even though seen only in a small fraction of cases (4 %), was only associated with RCC. On correlation with histopathological findings, a sensitivity of 95.8 %, specificity of 96.15 % and a diagnostic accuracy of 96 % was found, for diagnosing RCC in our study. CONCLUSIONS MDCT is a robust technique for detection and characterisation of renal mases. It is rapid and easily available with excellent patient compliance. MDCT has excellent sensitivity and specificity for characterisation of renal masses. KEY WORDS MDCT, Renal Mass, Renal Cell Carcinoma, Cyst, Attenuation, Enhancement

Histologic Heterogeneity of Extirpated Renal Cell Carcinoma Specimens: Implications for Renal Mass Biopsy

2020 ◽  
Vol 7 (3) ◽  
pp. 20-25
Author(s):  
Lauren Nahouraii ◽  
Jordan Allen ◽  
Suzanne Merrill ◽  
Erik Lehman ◽  
Matthew Kaag ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Mass ◽  
Tumor Stage ◽  
High Grade ◽  
Renal Masses ◽  
Histologic Heterogeneity ◽  
Adequate Sampling ◽  
Renal Mass Biopsy

Pathologic characteristics of extirpated renal cell carcinoma (RCC) specimens <7  cm were reviewed to get better information on technical nuances of renal mass biopsy (RMB). Specimens were stratified according to tumor stage, nuclear grade, size, histology, presence of lymphovas-cular invasion (LVI), necrosis, and sarcomatoid features. When considering pT1 (0–7 cm) tumors pT1b (4–7 cm), RCC masses were more likely to have necrosis (43% vs 16%, P < 0.001), LVI (6% vs 2%, P = 0.024), high-grade nuclear elements (29% vs 17%, P < 0.001), and sarcomatoid features (2% vs 0%, P = 0.006) compared with pT1a (0–4 cm) tumors. Additionally, pT3a tumors were more highly associated with necrosis (P = 0.005), LVI, sarcomatoid features, and high-grade disease (P for all < 0.001) when compared to pT1 masses. For masses <4 cm, pT3a cancers were more likely to demonstrate necrosis (38% vs 16%, P < 0.001), LVI (10% vs 2%, P = 0.037), high-grade nuclear elements (31% vs 17%, P = 0.05), and sarcomatoid features (3% vs 0%, P = 0.065) compared to pT1a tumors. Similarly, for masses 4–7 cm, pathologic T3a tumors were significantly more likely to have sarcomatoid features (16% vs 2%, P < 0.001) and LVI (28% vs 6%, P < 0.001) compared to pT1b tumors. In summary, pT3a tumors and those RCC masses >4 cm exhibit considerable histologic heterogeneity and may harbor elements that are not easily appreciated with limited renal sampling. Therefore, if RMB is considered for renal masses greater than 4 cm or those that abut sinus fat, a multi-quadrant biopsy approach is necessary to ensure adequate sampling and characterization of the mass.

scholarly journals Correlation between radiological and histopathological findings in patients undergoing nephrectomy for presumed renal cell carcinoma on computed tomography scan at Grey’s Hospital

2018 ◽  
Vol 22 (1) ◽  
Author(s):  
Nompumelelo E. Mlambo ◽  
Nondumiso N.M. Dlamini ◽  
Ronald J. Urry
Keyword(s):  
Computed Tomography ◽  
Renal Cell Carcinoma ◽  
Ct Scan ◽  
Cell Carcinoma ◽  
South African ◽  
Renal Cell ◽  
Vascular Invasion ◽  
Retrospective Chart Review ◽  
Renal Masses ◽  
Cross Sectional

Background: The incidence of renal cell carcinoma (RCC) is increasing globally owing to the increased use of cross-sectional imaging. Computed tomography (CT) scan is the modality of choice in the diagnosis and pre-operative assessment of RCC. Nephrectomy is the standard treatment for RCC and pre-surgery biopsy is not routinely practised. The accuracy of CT diagnosis and staging in a South African population has not been established.Objectives: To determine the accuracy of CT scan in the diagnosis and pre-operative staging of RCC at Grey’s Hospital.Methods: A retrospective chart review was performed; CT scan reports and histopathological results of adult patients who underwent nephrectomy for presumed RCC on CT scan between January 2010 and December 2016 were compared.Results: Fifty patients met the inclusion criteria for the study. CT significantly overestimated the size of renal masses by 0.7 cm (p = 0.045) on average. The positive predictive value of CT for RCC was 81%. Cystic tumours and those 4 cm and smaller were more likely to be benign. CT demonstrated good specificity for extra-renal extension, vascular invasion and lymph node involvement, but poor sensitivity.Conclusion: In our South African study population, CT is accurate at diagnosing RCC, but false-positives do occur. Non-enhancing or poorly enhancing, cystic, fat-containing and small lesions (4 cm or smaller) are more likely to be benign and ultrasound-guided biopsy should be considered to avoid unnecessary surgery. CT assessment of extra-renal extension and vascular invasion is challenging and additional imaging modalities such as magnetic resonance imaging (MRI) venogram, duplex Doppler ultrasound or Positron emission tomography–computed tomography (PET/CT) may be beneficial.

Treating the Two Extremes in Renal Cell Carcinoma: Management of Small Renal Masses and Cytoreductive Nephrectomy in Metastatic Disease

2014 ◽  
pp. e214-e221 ◽  
Author(s):  
Dae Y. Kim ◽  
Christopher G. Wood ◽  
Jose A. Karam
Keyword(s):  
Renal Cell Carcinoma ◽  
Targeted Therapy ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Mass ◽  
Cytoreductive Nephrectomy ◽  
Renal Cell Carcinomas ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Renal Mass Biopsy

OVERVIEW: The incidental renal mass represents a heterogeneous group that contains both benign and malignant pathologies. The majority of renal cell carcinomas are discovered incidentally, without the presence of symptoms directly related to the mass, and are closely associated with the term small renal masses because of the discovery before the onset of symptoms. In general, small renal masses are defined as 4 cm or smaller, and may account for greater than half of renal cell carcinoma diagnosis. The use of renal mass biopsy may offer additional pathological information but the clinician must be reminded of the technical and diagnostic limitations of renal mass biopsy. Patient-dependent factors, such as life expectancy and comorbidities, guide the management of small renal masses, which include active surveillance, partial nephrectomy, radical nephrectomy, and ablative techniques (cryoablation and radiofrequency ablation). Partial nephrectomy has demonstrated durable oncologic control for small renal masses while preserving renal function and, if feasible, is the current treatment of choice. In the other extreme of the renal cell carcinomas spectrum and in the presence of metastatic disease, the removal of the renal primary tumor is termed cytoreductive nephrectomy. Two randomized trials (SWOG 8949 and EORTC 30947) have demonstrated a survival benefit with cytoreductive nephrectomy before the initiation of immunotherapy. These two studies have also been the motivation to perform cytoreductive nephrectomy in the targeted therapy era. Currently, there are two ongoing randomized prospective trials accruing to investigate the timing and relevance of cytoreductive nephrectomy in the contemporary setting of targeted therapy.

Oncocytic Papillary Renal Cell Carcinoma in the Background of Renal Adenomatosis

2016 ◽  
Vol 25 (1) ◽  
pp. 78-82
Author(s):  
Ji Yeon Kim
Keyword(s):  
Computed Tomography ◽  
Renal Cell Carcinoma ◽  
Literature Review ◽  
Cell Carcinoma ◽  
Rare Disease ◽  
Renal Cell ◽  
Malignant Tumors ◽  
Papillary Renal Cell Carcinoma ◽  
Renal Masses ◽  
Cytological Features

Renal adenomatosis is a rare disease characterized by numerous adenomas in bilateral kidneys. A literature review shows that malignant tumors can arise in this condition. The present case describes an oncocytic papillary renal cell carcinoma (PRCC) arising in renal adenomatosis. A 70-year-old man presented with incidentally identified, multiple right renal masses on computed tomography. Right nephrectomy was performed, and the resected kidney revealed numerous radiologically undetected small nodules additionally. Microscopically, the nodules were papillary neoplasms of variable sizes and cytological features. The largest nodule measured 1.6 cm and was composed of oncocytic cells, meeting the diagnostic criteria of oncocytic PRCC. The smaller nodules of papillary adenomas and tiny lesions showing a single papillary ingrowth were also seen. This case exhibits a spectrum of renal papillary neoplasms in a resected kidney and can be a valuable case in the understanding of tumorigenesis.

CTLA-4andCD28genes' polymorphisms and renal cell carcinoma susceptibility in the Polish population - a prospective study

2015 ◽  
Vol 86 (5) ◽  
pp. 353-361 ◽  
Author(s):  
K. Tupikowski ◽  
A. Partyka ◽  
A. Kolodziej ◽  
J. Dembowski ◽  
P. Debinski ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prospective Study ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Polish Population ◽  
A Prospective Study

Abstract B124: A prospective study of one-carbon metabolism biomarkers and risk of renal cell carcinoma.

2008 ◽  
Author(s):  
Todd Gibson ◽  
Stephanie Weinstein ◽  
Susan Mayne ◽  
Jacob Selhub ◽  
Philip Taylor ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prospective Study ◽  
Cell Carcinoma ◽  
Carbon Metabolism ◽  
Renal Cell ◽  
One Carbon Metabolism ◽  
A Prospective Study
Sign in / Sign up

Export Citation Format

Share Document