Renal cell carcinoma diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
A needle biopsy should always be performed when the finding of a renal mass is detected on imaging.
Diagnostic Study of Choice
A needle biopsy should always be performed when the finding of a renal mass is detected on imaging.
Needle Biopsy
Needle biopsy should always be performed when the finding of a renal mass is detected on imaging. CT or MRI guided needle biopsy distinguishes between different subgroups of renal cell carcinoma and identifies management: active surveillance, surgery, or medical therapy.[1] The sensitivity and specificity of needle biopsy are very high. The rate of biopsy-related complications, including biopsy-associated seeding, is considered very low.[1]
| Type | Characteristic Features |
| Conventional (Clear Cell) | *Nests of tumor cells that are compacted near each other *Clear cytoplasm *Delicate vasculature that separates the cytoplasm *Varying architectural patterns, such as solid, alveolar, or acinar |
| Papillary | *Papillae, tubulopapillae, and tubules that are present in differing percentages *Type I generally has papillae lined with only 1 layer of cancer cells, pale cytoplasm, and small oval nuclei *Type II generally are more heterogeneous tumors that have pseudostratification with large, spherical nuclei and distinct nucleoli |
| Chromophobe | *Large polygonal cells *Finely reticulated cytoplasm that may be eosinophilic *Distinct cell borders *Atypical nuclei with perinuclear halo |
References
- ↑ 1.0 1.1 Donat SM, Diaz M, Bishoff JT, Coleman JA, Dahm P, Derweesh IH; et al. (2013). "Follow-up for Clinically Localized Renal Neoplasms: AUA Guideline". J Urol. 190 (2): 407–16. doi:10.1016/j.juro.2013.04.121. PMID 23665399.
- ↑ Cohen HT, McGovern FJ (2005). "Renal-cell carcinoma". N Engl J Med. 353 (23): 2477–90. doi:10.1056/NEJMra043172. PMID 16339096.
- ↑ Rini BI, Campbell SC, Escudier B (2009). "Renal cell carcinoma". Lancet. 373 (9669): 1119–32. doi:10.1016/S0140-6736(09)60229-4. PMID 19269025.