Renal biopsies carried out by ultrasonography using an 18-G needle provide adequate histological analysis, showing a lower amount of glomeruli but with similar clinical quality as a 16-G needle. Furthermore, it is associated with a lower risk of procedure-related complications.
We report a rare case of cardiac angiosarcoma in a female adolescent patient that is an unusual case of cardiac angiosarcoma. As the initial symptoms are nonspecific our case demonstrated difficulty to establish the correct diagnosis. Our patient has in addition to these, malaise, diarrhea and hemoptysis which was mistakenly diagnosed with pneumonia. Here, we discuss aspects of computed tomography with a definitive diagnosis confirmed by immunohistochemistry, through a transthoracic radioguided biopsy. The patient presented improvement after urgent chemotherapy, however, she died 4 months after initial symptoms. In view of these aspects, it is clear the need for early diagnosis and a definition of optimized treatment in order to extend the survival of these patients.
Renal physiology and physiopathology have been the object of studies aimed at developing exams that can assist in the early diagnosis of the base disease. Chronic kidney disease consists of the progressive, irreversible loss of kidney function. Early detection and appropriate treatment can minimize the progression of the disease, lower the inherent costs, and improve the quality of life of affected individuals. Kidney biopsy is the key method in this evaluation, as it enables the histological and immunohistochemical analysis of specimens in a fast, safe, and economical manner. The main indications for kidney biopsy are nephrotic syndrome, acute kidney failure of unknown etiology, persistent hematuria and proteinuria, chronic kidney disease with conserved kidney dimensions, and transplanted kidneys (to evaluate stages of rejection, infection, and/or sclerosis). However, as an invasive method, kidney biopsy is not without complications. Post-biopsy complication rates range from 5 to 15%, with 6.6% considered minor (macrohematuria with no need for blood transfusion) and another 7.7% considered major (hemorrhage requiring blood transfusion or other approaches). In this chapter, we address the main aspects of kidney biopsy, the technical procedures for its execution, and the management of the main complications stemming from this procedure.
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