Renal oncocytoma other diagnostic studies: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
m (Bot: Removing from Primary care)
 
(One intermediate revision by one other user not shown)
Line 36: Line 36:
* [[Pneumothorax]] ( during biopsy of upper pole tumors)
* [[Pneumothorax]] ( during biopsy of upper pole tumors)
* [[Tumor]] seeding
* [[Tumor]] seeding
Needle biopsy of the tumor can be a useful strategy to diagnose oncocytoma in the very elderly or very sick patient with a renal tumor. There have been cases reported in which patients with large bilateral and unresectable renal oncocytomas have been observed for many years without showing distinct tumoral progression. Such observational treatment may be entirely appropriate for patients at poor operative risk because of extensive comorbidities
Core needle biopsies are increasingly used in the diagnosis of renal masses (Figure 3). Because 20–45% of small renal masses are ultimately found to be benign, active surveillance is an option for many patients (38, 39). The diagnostic accuracy of renal mass biopsy remains somewhat controversial,
however. Individual groups have reported up to 80% diagnostic rate from renal mass biopsy, with the ability to provide
subtype and nuclear grade in the majority of diagnostic biopsies (40). Unfortunately, oncocytic lesions can be especially troublesome in renal mass biopsy, as interpreting only a limited sampling
of tumor may not be representative of the entire lesion. A meta-analysis of 205 oncocytic renal mass biopsies from
2017 showed that the positive predictive value for a diagnosis
of oncocytoma on renal mass biopsy was 67% with significant heterogeneity and wide confidence interval, indicating
that the diagnostic accuracy varies greatly between studies and, by extrapolation, between pathologists (41). For renal mass biopsies of oncocytic neoplasms, there is a
split among urologic pathologists as to whether it is preferable to issue an outright diagnosis of oncocytoma (when features
are typical in the biopsy sample) or to use more general
terminology, such as “oncocytic neoplasm,” with comment that the features are compatible with oncocytoma (5). In the context that morphologic and immunohistochemical features are largely compatible with oncocytoma, yet in which there
are minor equivocal features, such as variation in cell size
or slight nuclear irregularity, it is also reasonable to utilize
a borderline diagnostic category expressing uncertainty between oncocytoma and eosinophilic variant chromophobe
renal cell carcinoma. In this setting, immunohistochemical staining may also be helpful. Although CK7 staining may not
be beyond the expected level of oncocytoma, findings such as
negative vimentin staining and positive KIT staining generally
argue against other considerations, such as papillary or
clear cell renal cell carcinoma with eosinophilic cells. Since chromophobe renal cell carcinoma, especially the eosinophilic
variant, is also generally regarded as a less aggressive
tumor subtype, this can facilitate appropriate management in patients who are candidates for nonsurgical treatment (42).
Conversely, if nuclear or cytologic features are inconsistent with oncocytoma (non-degenerative atypia, nuclear membrane
irregularity, or perinuclear clearing), a diagnosis of eosinophilic
variant of chromophobe renal cell carcinoma may be favored.
==References==
==References==
{{reflist|2}}
{{reflist|2}}
Line 73: Line 46:
[[Category:Oncology]]
[[Category:Oncology]]
[[Category:Nephrology]]
[[Category:Nephrology]]
[[Category: Primary care]]

Latest revision as of 23:57, 29 July 2020

Renal oncocytoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Renal oncocytoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Renal oncocytoma other diagnostic studies On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Renal oncocytoma other diagnostic studies

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Renal oncocytoma other diagnostic studies

CDC on Renal oncocytoma other diagnostic studies

Renal oncocytoma other diagnostic studies in the news

Blogs on Renal oncocytoma other diagnostic studies

Directions to Hospitals Treating Renal oncocytoma

Risk calculators and risk factors for Renal oncocytoma other diagnostic studies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2]

Overview

Renal mass biopsy may be helpful in the diagnosis of renal oncocytoma. However, distinguishing between oncocytoma and RCC by biopsy is difficult. Since this method only reserved for patients who are at high risk for an operation like very elderly or extremely sick patients. Some complications may happen during renal mass biopsy which are perirenal hemorrhage, pneumothorax ( during biopsy of upper pole tumors) and tumor seeding.

Other Diagnostic Studies

Biopsy:

Renal mass biopsy may be helpful in the diagnosis of renal oncocytoma. However, distinguishing between oncocytoma and RCC by biopsy is difficult. Since this method only reserved for patients who are at high risk for an operation like very elderly or extremely sick patients. [1][2]

Complications of renal mass biopsy include:[3][4][5][6][7]

References

  1. ↑ Haifler, Miki; Copel, Laurian; Sandbank, Judith; Lang, Erez; Raz, Orit; Leibovici, Dan; Lindner, Arie; Zisman, Amnon (2012). "Renal oncocytoma—are there sufficient grounds to consider surveillance following prenephrectomy histologic diagnosis". Urologic Oncology: Seminars and Original Investigations. 30 (4): 362–368. doi:10.1016/j.urolonc.2009.11.024. ISSN 1078-1439.
  2. ↑ Stephen M. Schatz & Michael M. Lieber (2003). "Update on oncocytoma". Current urology reports. 4 (1): 30–35. PMID 12537936. Unknown parameter |month= ignored (help)
  3. ↑ Lane, Brian R.; Samplaski, Mary K.; Herts, Brian R.; Zhou, Ming; Novick, Andrew C.; Campbell, Steven C. (2008). "Renal Mass Biopsy—A Renaissance?". Journal of Urology. 179 (1): 20–27. doi:10.1016/j.juro.2007.08.124. ISSN 0022-5347.
  4. ↑ Hara, Isao; Miyake, Hideaki; Hara, Shoji; Arakawa, Soichi; Hanioka, Keisuke; Kamidono, Sadao (2001). "Role of Percutaneous Image-Guided Biopsy in the Evaluation of Renal Masses". Urologia Internationalis. 67 (3): 199–202. doi:10.1159/000050987. ISSN 0042-1138.
  5. ↑ P. W. Ralls, J. A. Barakos, E. M. Kaptein, P. E. Friedman, G. Fouladian, W. D. Boswell, J. Halls & S. G. Massry (1987). "Renal biopsy-related hemorrhage: frequency and comparison of CT and sonography". 11 (6): 1031–1034. PMID 3316324. Unknown parameter |Journal= ignored (|journal= suggested) (help); Unknown parameter |month= ignored (help)
  6. ↑ Hopper, K D; Yakes, W F (1990). "The posterior intercostal approach for percutaneous renal procedures: risk of puncturing the lung, spleen, and liver as determined by CT". American Journal of Roentgenology. 154 (1): 115–117. doi:10.2214/ajr.154.1.2104692. ISSN 0361-803X.
  7. ↑ Silverman, Stuart G.; Gan, Yu Unn; Mortele, Koenraad J.; Tuncali, Kemal; Cibas, Edmund S. (2006). "Renal Masses in the Adult Patient: The Role of Percutaneous Biopsy". Radiology. 240 (1): 6–22. doi:10.1148/radiol.2401050061. ISSN 0033-8419.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Renal_oncocytoma_other_diagnostic_studies&oldid=1642783"